Coming to a physician near you

I’ve had more encounters with doctors this year than I have in the last several combined, and one thing I have come to appreciate is the magnitude of the difference between the good ones and the mediocre ones. Sarah’s battles with her health over the past several years have given us knowledge of pretty much the absolute best doctors in the Washington area, and this has definitely worked to my advantage.

Sarah’s last two PCPs have taken on the “gourmet medicine” approach (MDVIP and Privia are the two flavors I’ve encountered). I saw one of my doctors today (a very good one), told me that this will become a lot more common with the new health care law, and she recommended that if the doctor you like joins that type of arrangement, it’s actually worth it to sign up. In addition, about half or more of her (and my) physicians participate in exactly 0 insurance programs, so if you want to see them, it’s a flat rate out of pocket (and rarely is that rate low).

Now, on the one hand, this is market forces bursting through the fog of the modern insurance-driven system – I’m in favor of allowing pricing signals to reach the consumer, so that he or she can include price in his or her decision making. On the other hand, this means that the best doctors (i.e. the ones we went to after we had seen the rest) are not available at all to people without financial means to afford them. The gripping hand, however, is that the regulatory scheme which the country is moving toward will tend to decrease the pricing signals to the consumer and merely ration the care of those people who can’t afford to wholly opt-out of the system. This strikes me as the least desirable outcome, and for all of the talk of outcome-based medicine, this sure doesn’t seem like we’re moving in the right direction.


About thegameiam
I'm a network engineer, musician, and Orthodox Jew who opines on things which cross my path.

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