Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Why Do We Need Insurance To Cover Primary Care Costs?

As a primary care practitioner, I often am baffled by why Americans need insurance for primary, or day-to-day, care issues. When I’m talking about primary care, I mean those health problems that are considered routine, or day-to-day, problems including ear infections to poison ivy as well as many urgent care issues like sutures and draining infections. These account for a large portion of all health problems that occur in the U.S – and 80% of the things that typically up in the ER or urgent care.

My understanding is that the purpose of insurance is to protect our financial well-being and thus our financial nest egg. Investorpedia, which is part of Forbes Digital Media, offers the following definition: “Insurance allows individuals, businesses and other entities to protect themselves against significant potential losses and financial hardship at a reasonably affordable rate.”

This definition explains why we invest in insurance of all types: car insurance, home insurance and health insurance.

Then I wonder why our expectations and utilization of health insurance differs so significantly from home or car insurance. I pay a monthly premium for my car insurance, and it protects me against having to pay out large sums of money if I would be in a bad car accident. I don’t expect, however, my car insurance provider to pay for an oil change or new battery. Likewise, I pay a yearly premium for my home owner’s insurance, yet I do not expect the insurance company to foot the bill if I need a new screen door – but I certainly will turn to them if a tree crashes through my garage during a bad storm.

Then why should I expect my health insurance to pick up every small, day-to-day health issue that I have, particularly those that can cost less then $150, like a well-woman physical, help with pink eye, a tick bite or extricating a fish hook?

Don’t get me wrong; I feel that health insurance is a must to protecting anyone’s financial assets against a potentially catastrophic health event, like a tragic accident or illness. We all need to be ensured that we will not go broke if we are faced with such health issues.

I currently work for a primary care practice, DocTalker, is built to deliver affordable access to our medical team, round the clock, to ensure that our patients save cost and time. Our patients pay for a doctor’s fees when service is rendered. We base the fee structure on time and materials; our patients pay us for the amount of time they spend with the medical team. An office visit typically lasts for 15 minutes and costs $75. Believe it or not, roughly 75% of our patients pay less than $300 per year for their primary and urgent care health issues. I know of a lot of people who pay that in one office visit to the vet!

Our philosophy is that the faster we can talk to and treat our patients, the faster they will get better, thus saving them time and money from lost work, not to mention saving them in expenses from waiting to treat a condition that can worsen with time (like bronchitis). Once we’ve met with a patient face-to-face, we offer phone and email consultations, which typically cost $50.

The other thought is that if people pay, out-of-pocket, for their day-to-day care problems, then they will be more like to be aware of the cost and quality of the care they receive – much like they are with that vast majority of other purchases that they make, from a car to cell phone service to food. This will cause the consumer to demand a higher quality of care for a better price, and will lead to consumer choice and thus to consumer’s driving the market.

I don’t think that a price tag of $300 for the care of majority of primary and urgent care problems is really that much to ask; after all, many of us pay this much when we have a plumber come to the house to unplug a sink.

I think that my health is worth as much as an unplugged sink. I believe we do can it at a less expensive price. Don’t you?

Until next week, I remain yours in primary care,

Valerie Tinley, FNP-BC

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »