Although I loved my previous doctor, I had a difficult time scheduling a timely appointment with her. When I last called, I was told I’d have to wait three months to schedule a routine physical. Such delays are not unusual; many Americans—including many of my friends—are having trouble getting in to see a doctor in a timely manner (although for serious emergencies Americans almost always receive fast and excellent care).
Contrast my physical exam with that of my cat. When I called my veterinarian’s office last month, I was able to schedule my cat’s routine exam within days, and she received top-notch care, complete with detailed blood analysis. Why is it, I thought, that my cat has better access to health care than I have?
Or contrast my experience with the typical experience involving any other service industry. If you call your mechanic and ask to schedule a tune-up, and he tells you you’ll have to wait three months, you’ll say “that’s ridiculous” and go somewhere else.
Why is the service Americans get from primary care doctors often substantially worse than the service we get from our veterinarians, mechanics, dentists, eye doctors, package deliverers, and so on? Here are a few indicators:
- For decades the federal government has, through tax policies, pushed employers to provide employees with health insurance that covers not only emergencies and high-cost procedures but also routine care.
- Consequently, many Americans pay for all their health care through insurance. This setup hides costs from both patients and doctors, and it creates massive paperwork costs for the simplest doctor visits. These costs and consumptions of the doctors’ time dramatically reduce the time they are able to spend with patients.
- Through its massive Medicare welfare program, the government also largely dictates the fees that doctors can collect for their services. Because this reduces the amount of money doctors earn and burdens them with bureaucratic paperwork, many doctors are quitting, and fewer bright students are entering the field of family medicine.
- The government’s health care payments and regulations are increasingly pushing doctors into large, regimented practices in which their time with patients is further limited.
Thankfully, my story has a happy ending: I found a “concierge” family practice in my area, similar to that of Dr. Josh Umbehr (whom I interviewed for the Fall issue of TOS). The practice accepts no insurance, provides many tests at cost, and charges a relatively low monthly fee (which my wife and I pay from our Health Savings Account). I was able to schedule my physical within days, and my new doctor was able to spend a full, unhurried hour with me.
In his TOS interview, Umbehr perfectly described the sort of service I was looking for and ultimately found:
Patients want . . . better care for less money. They want better value. They want more time with their doctors. They want quality and convenience and accessibility and all the things that we’re not offering to them right now. They want their doctors to answer the phone. They want their doctors to supply their medicine. They want their doctors to sit down and spend half an hour or an hour with them and not worry about what insurance is going to pay for or not pay for.
Taxes and regulations are driving much of health care further into the morass of bureaucratic, paperwork-driven practice. If Americans want to save health care from utter catastrophe in the long run, we clearly must continue to fight for the protection of the rights of doctors, insurers, and patients.
In the meantime, concierge medicine offers a way to escape some of the worst consequences of government interference to date. If you’ve not yet inquired about concierge medicine in your area, I encourage you to do so—you might like what you find.
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