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.”

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″

Brekke’s “Paying for Primary Care”, Comment on Part 1

In the winter of 2021, actuary Gayle Brekke penned a four–part–blogpost–series arguing that the cost of insurance primary care delivery in the insurance system is at least 50% higher the cost of delivering primary care through subscription model DPC. Notably, Brekke’s work was theoretical rather than empirical; she attempted to compute the relative costs ofContinue reading “Brekke’s “Paying for Primary Care”, Comment on Part 1″

New DPC leader is incredible – unfortunately, not in the good way.

Let’s meet Cladogh Ryan MD, one of the new board members for DPC Alliance for 2021 who picked up the torch from some of those golden oldies. Dr Ryan cranked up a town meeting style event to recruit some of her Cook County, IL, fee-for-service patients into her new enterprise, Cara Direct Care. She layedContinue reading “New DPC leader is incredible – unfortunately, not in the good way.”

Nextera and Paladina (Everside): a race to the top of Mount Brag

Updated 9/4/21 In 2015, Qliance still towered over all in the Direct Primary Care Bragging World with its claim of 20% overall cost reductions. Even that, of course, was quite a come down from the extravagant claims previously spewed under the Qliance banner; fond memories still linger of those heady days when the Heritage FoundationContinue reading “Nextera and Paladina (Everside): a race to the top of Mount Brag”