Why a policy wonk like Wyden might (and, perhaps, should) kill a DPC/HDHP fix for subscription medicine. Short version.

A 1.8 billion dollar subsidy to support subscription-model contraction of primary care patient panel sizes is a problematic policy in a country when there is a shortage of primary care physicians. I came to this trying to figure something out. We hear that Ron Wyden kept the DPC/HDHP fix for subscription fees out of theContinue reading “Why a policy wonk like Wyden might (and, perhaps, should) kill a DPC/HDHP fix for subscription medicine. Short version.”

Nice try!

October 20, 2019: 500+ word Open Letter to Members of Congress by DPC Coaltion President asking for support and co-sponsorship of the The Primary Care Enhancement Act. Missing words: telehealth, telemedicine, telephone, phone, text message, text, SMS. March 26, 2020: DPC Coalition laments exclusion of the bill from CARES despite being sold as “means ofContinue reading “Nice try!”

Why a policy wonk like Wyden might (and, perhaps, should) kill a DPC/HDHP fix for subscription medicine.

Drafty fuller version Click me for shorter, more polished version which you may (a) prefer and/or (b) have already seen. A 1.8 billion dollar subsidy to support subscription-model contraction of primary care patient panel sizes is a problematic policy in a country when there is a shortage of primary care physicians. I came to thisContinue reading “Why a policy wonk like Wyden might (and, perhaps, should) kill a DPC/HDHP fix for subscription medicine.”

The “DPC is uniquely able to telemed” train has left the station. Everyone is telemeding now.

October 20, 2019: 500+ word Open Letter to Members of Congress by DPC Coaltion President asking for support and co-sponsorship of the The Primary Care Enhancement Act. Missing words: telehealth, telemedicine, virtual, telephone, phone, text message, text, SMS. March 26, 2020: DPC Coalition laments exclusion of the bill from CARES despite being sold as “meansContinue reading “The “DPC is uniquely able to telemed” train has left the station. Everyone is telemeding now.”

Pandemic effects on DPC enrollment

Possibilities to think about: DPC members who lose employer coverage will have the ability to go to ACA-compliant marketplace plans. Many of these will reach the low income levels at which ACA provides robust cost-sharing reduction is available. The relative desirability of DPC will fall. Some DPC members who lose income will become Medicaid eligible,Continue reading “Pandemic effects on DPC enrollment”

Direct Primary Care & COVID-19: some takes on Dr. White’s piece on dpcalliance.com

Next post will be linked here, then new post likely will be pinned near top of blog. Not sure yet the degree to which the next post will supplement, incorporate, rearrange, just replace this one, maybe none of these. This one is mostly reactive to Dr White’s DPCAlliance.com essay on DPC and COVID-19. That wasContinue reading “Direct Primary Care & COVID-19: some takes on Dr. White’s piece on dpcalliance.com”

Dr Priceline’s downstream cost reduction plan cannot simply be scaled up.

Dr. Lee Gross of Epiphany, a direct primary care leader, brags about the great discounts he gets for his patients on downstream procedures like advanced radiology. And, specifically, he proudly lets us know that a big part of this involves accessing advanced equipment during slack hours. This is, of course, the same strategy by whichContinue reading “Dr Priceline’s downstream cost reduction plan cannot simply be scaled up.”

I actually hope that many doctors who have engaged in policy advocacy were blinded by ideology, or simply lying.

I see so much bad analysis and arithmetic in policy advocacy by MDs, I have to hope that it’s a result of ideological blind spots, or even outright lying. I am frightened by the principal alternative explanation: that one can too easily become an MD despite the lack of basic analytical or arithmetic skills.

Making cost reduction claims more honest and helpful to decision-makers — random thoughts.

Claims of cost reductions need to look comprehensively at all costs. Consider this chart from an Iora presentation of some years ago. The net drop in spending would look a lot bigger if prescription drugs (the green bar) were not part of the picture. But, a lot of how primary care, direct or otherwise, worksContinue reading “Making cost reduction claims more honest and helpful to decision-makers — random thoughts.”