Despite his longtime DPC advocacy, Dr Forrest’s work has yet to receive proper respect. For example, even despite his having publicized its astonishing findings, many do not recall that Forrest directed a team of NCSU graduate business students in canvassing the entire Raleigh area to observe directly the amount of time FFS-PCPs were actually spendingContinue reading “Brain Forrest, MD”
Author Archives: Gary Ratner
As important as overhead expenses are in the economics of PCP practice, measuring overhead costs as a percentage of revenue can be profoundly unhelpful.
After attaining a certain measure of success and a spreading reputation, an illustrator can vastly increase his prices and still sell his entire output, and do so without incurring added costs for pencils, paint, paper, other studio supplies or studio space. Revenue up; no change in overhead costs; overhead costs as a percentage of revenueContinue reading “As important as overhead expenses are in the economics of PCP practice, measuring overhead costs as a percentage of revenue can be profoundly unhelpful.”
Quick guide/recap for Brekke’s “Paying for Primary HealthCare” and my responses
In an e-book and blog about paying for primary care, Gayle Brekke presents an argument laced with actuarial theory and jargon, calculations, notes, and citations. An appearance of scholarly pursuit and mathematical precision is thereby created; in both blog and e-book Brekke makes clear that she is an experienced actuary who is also deep intoContinue reading “Quick guide/recap for Brekke’s “Paying for Primary HealthCare” and my responses”
The mathmatical core of Brekke’s “Paying for Primary Healthcare rests is not reasonably supported by the sources to which Brekke points.
Because paying for primary care with insurance incurs administrative costs not encountered in direct pay models, a case can be made that direct primary care should cost a patient less than insured primary care. But most DPC advocates are themselves PCPs and they have little to gain from offering discount pricing and much to gainContinue reading “The mathmatical core of Brekke’s “Paying for Primary Healthcare rests is not reasonably supported by the sources to which Brekke points.”
In rural areas, decreased primary care panel size is a problem, not a solution.
Montana’s last governor twice vetoed DPC legislation. He was not wrong. Over the last month or so, DPC advocates from think-tanks of the right have trotted out the proposition that direct primary care could be “the key to addressing disparities in health care access in underserved areas of Montana facing severe shortages of primary care”.Continue reading “In rural areas, decreased primary care panel size is a problem, not a solution.”
Try due diligence before betting the health of your employees on Lee-Gross-style Direct Primary Care
In his latest Direct Primary Care slide-show brag, attributing significant overall medical cost reduction for employees electing DPC over and FFS primary care alternative offered by the same employer, Dr Lee Gross insists that the favorable results do not reflect “cherry picking”. And yet, Dr Gross fails to compare the health status of the DPC-coveredContinue reading “Try due diligence before betting the health of your employees on Lee-Gross-style Direct Primary Care”
Including Primary Care in Health Insurance Policy Coverage with Insurance Is Reasonable
The missing part 5 of Brekke’s “Paying for Primary Care”, a comment. Under the traditional insurance model, patients receiving covered primary will indirectly pay significant administrative costs, but they may also gain compensating financial advantages that Gayle Brekke’s multipart “Paying for Primary Care” series fails to recognize, ignores, or minimizes. At the top of theContinue reading “Including Primary Care in Health Insurance Policy Coverage with Insurance Is Reasonable”
Brekke’s “Paying for Primary Care”, Comment on Part 4
In the first three installments of her Paying for Primary Care series, actuary Gayle Brekke’s invoked actuarial principles and behavioral economics to scold coverage of primary care on the ground that the costs of primary care are “predictable, routine, likely events over which the customer has a great deal of control”. In her fourth installment,Continue reading “Brekke’s “Paying for Primary Care”, Comment on Part 4″
Brekke’s “Paying for Primary Care”, Comment on Part 3
In Part 3 of Paying for Primary Care, Gayle Brekke discourses on the behavioral economics of shared health cost arrangements to conclude that insuring primary care adds costs not seen in direct pay. These cost, she contends, simply add on to the 50% administrative cost burden of insurance she had already she had already declaredContinue reading “Brekke’s “Paying for Primary Care”, Comment on Part 3″
Brekke’s “Paying for Primary Care”, Comment on Part 2
In Part 1 of “Paying for Primary Care”, actuary Gayle Brekke (mis)computed the provider side administrative cost burden of paying for primary care insurance at about 28%; in a response, I showed it likely that the true number was less than 9%, indicting that Brekke had inflated by more than three fold. Now we turnContinue reading “Brekke’s “Paying for Primary Care”, Comment on Part 2″
DPC Referee 