Although I’ve mostly figured out how to get my financial life in order, other aspects of my life still need work. For example, I’ve visited a physician only a few times over the past ten years. I should be seeing a doctor about once a year if I were to listen to the typical medical advice. With my medical insurance provider changing four times in the last two years, it’s been even more difficult for me to nail down some consistency in medical coverage. But that’s just an excuse.
As an independent contractor, it’s up to me to find and pay for medical insurance — and this isn’t cheap in the state of New Jersey. An increasing number of people in my situation — as well as those who do have employer-provided insurance — are turning towards concierge medicine.
The type of care provided by doctors who follow the concierge model is more like the medical care of the past: doctors have fewer patients and build personal relationships, make house calls, and in many cases, earn a better living than they would when dealing with insurance companies.
For a monthly retainer fee, a patient can have access to their family physician at any time.
There are great benefits to this model, but it can’t replace insurance completely, particularly not for people who aren’t rich. Concierge medicine has been a service consumed by the wealthy, but as it has been growing in popularity, the idea is increasingly gaining traction among those who are not as flushed with cash. The concierge model is not a replacement for insurance. It’s fine when all you need to deal with is a physician, but specialists can cause problems.
Treatment not handled by a physician can be expensive. This is how people without insurance can find themselves in debt that they can’t overcome. One operation can cost hundreds of thousands of dollars without insurance, and concierge medicine does nothing to solve that problem. It cannot be a full replacement for insurance — or it can be, until a patient needs anything more than basic medical care.
The career situation for physicians is difficult, and moving from insurance to a concierge practice is one way for their industry to survive and thrive. Many of the best medical students turn towards a specialty because the compensation is so much better, as a result of the way insurance companies reimburse doctors for services. Compensation is not just the simple issue of supply and demand, but that has something to do with it as well.
Society still needs primary care physicians even though they don’t make as much money as specialists for the most part. To justify the ever-increasing cost of medical school, doctors need to seek higher compensation. A concierge model can increase the annual income of a practice. For the patient, however, the typical concierge medicine approach is incomplete. Insurance is still necessary — though perhaps an insurance plan that includes only catastrophic coverage — because once you need a specialist, without insurance, you’ll need to pay for your care out of your pocket.
Would you be willing to pay a monthly retainer fee for more direct access to your physician? How would you then cover yourself for any procedure or treatment your physician might not be able to handle? Is concierge medicine still only a reasonable health care option for the wealthy? With the Affordable Care Act, designed to encourage insurance for all citizens, is concierge medicine a viable option?
Published or updated November 26, 2012.