“Pay as you go” or “concierge medicine” it’s called today.
- In 1960, private patients paid 67% of the aggregate bill for physicians’ consultations. In 2014, private patients paid 11%.
- In 1992, private insurance increased to 50% of spending on physicians and has remained steady since.
- In 2014, the federal government’s share increased to 27% (Medicare) and 13% (Medicaid and Children’s Health Insurance Program).
Jay Parkinson, MD, founder of Sherpaa Medical Service, claims that house calls went out of fashion because they were a grossly inefficient use of very expensive physician time and extremely limited capability. While that makes sense, Graham responds in a Forbes article that “the almost complete elimination of house calls has not increased efficiency, it has only transferred the cost of travelling and waiting from doctors to patients.”
Some data—care of Keith Wagstaff of NBC News—paint a different picture:
- The average American lost $43 in wasted time waiting for a scheduled appointment–more than the amount of the out-of-pocket payment!
- The time spent actually consulting the doctor has shrunk to maybe 15 minutes.
Well, the good news is that the “so retro” idea of house calls has been making a slow but steady come back since 2012 under the moniker “connected care.” This promising approach refers to an array of digital tools that make it possible for physicians to contact, meet, and monitor their patients virtually whether online or via smartphones.
Some believe that connected care could increase the quality of care at a lower cost. That’s Dr. Parkinson’s hope and The Motley Monk’s, too. But as long as the government is involved, The Motley Monk believes that hoped-for outcome is probably nothing more than a hope or even hype. Ask: Since when has anything the government has gotten involved in become cheaper, that is, “bent the cost curve down” to those who pay taxes?
The Motley Monk recalls the late 1950s when Illinois voters were promised that once the proposed toll roads were paid off, they’d be “freeways” once again. Ha!
Let the discussion begin…
To access the souces cited in this post, click on the following links: