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The Unmet Need In Healthcare

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It is no secret that access to quality healthcare has changed dramatically in our country over the last several years.

Why Has Healthcare Gone Downhill in America?

Much of this change simply stemmed from a growing number of healthcare plans and platforms that provide insurance coverage masked under huge, sky-high deductibles. These plans are no different than an uninsured individual UNTIL the deductible is met.

Many patients carry anywhere from $1,800 to $12,000 annual health insurance deductibles! There are also various health insurance plans available for “nominal” ($180 to $450) monthly premiums yet $50 per every doctor visit is also required, among other hidden fees.

It is nearly impossible to meet these annually imposed deductibles of $1000s per year and actually benefit, as an individual patient, from the health insurance “coverage” being offered.

Before you know it, the year is coming to an abrupt end and the deductible starts over (once again!) on January 1. These plans are similar to “catastrophic health insurance”, meant to be utilized in the unfortunate occurrence of a very costly procedure or lengthy, devastating and incredibly expensive hospitalization. In such a case the patient is still obligated to pay the entire deductible prior to any insurance coverage actually being implemented!

Not Only Are High Deductibles Problematic – So Are Expensive Co-Pays and Hidden Costs

In addition to sky-high deductibles, many health insurance plans often incorporate expensive co-pays and other tiers of hidden costs and payments as well, for often necessary medications and/or required procedures.

Nowadays, there are so many health insurance plans and levels of service, it is virtually impossible to make heads or tails out of what is and is not covered and what is the patient’s responsibility or obligation. All too often, office staff spends time calling the insurance carrier(s) and asking for specifics and details, with countless minutes and hours spent waiting on the phone, while simply trying to assist the patients and prevent them from incurring unnecessary costs.

Shortage of Primary Care Doctors Contributes to Issue

In the rare event that a fortunate individual has the “perfect” health insurance with minimal co-pays, minimal deductibles, and full comprehensive, diamond coverage, immediate ACCESS to one’s Primary Care Doctor is often limited, simply due to an annual & inevitably increasing shortage of Primary Care Doctors.

It is this drastic shortage in timely and convenient access that has led to the advent of urgent care centers, overcrowded emergency rooms and a growing number of midlevel providers, physician assistants and nurse practitioners.

The joy of primary care medicine has been overshadowed by extremely limited time for patient visits due to the fact that private primary care practices must be volume driven in order to be viable and sustain themselves. They receive no stipends, facility fees and/or any other supplemental increase in reimbursements, unlike hospital owned and operated practices. In addition, overhead must always be accounted for, as landlords do not let a Doctor forego rent and employees must be paid regularly and on time.

Many patients cannot get in to see their Primary Care Doctor, often for weeks, and when they do, they often feel rushed and pushed out. This is, unfortunately, the sad truth and there is no apparent light at the end of this dismal primary care tunnel.

The fact that fewer and fewer graduates are choosing the grueling reality of primary care as their career path of choice, is only going to worsen the shortage and inevitably make access to a Primary Care Doctor (MD or DO), even more difficult.

How to Fix the Unmet Need in Healthcare

In this day and age, we are an increasingly and largely membership driven society. We purchase gym & health club memberships. We purchase spa & massage memberships. We purchase warehouse retail memberships among other memberships, that provide us the peace of mind knowing we have personalized and convenient access, at an often discounted & reduced rate. Many of these membership rates are $99 to $150 per month, if not more.

Concierge healthcare is also a membership driven concept, limiting patient panels for concierge care doctors, in the effort to provide the same or next day appointments, as well as cell phone and e-mail access to your concierge care Doctor, anytime, anywhere.

Concierge healthcare has predominantly been a service most often appreciated and utilized by the wealthy and affluent. Some plans charge as much as $4,000 per year for individuals, with other plans charging upwards of $25,000 per year for a family of four. The average concierge healthcare plan ranges from $1,500 to $1,800 per year per individual.

Concierge healthcare has been a concept that originally started as a luxury, over a decade ago, but is now becoming an increasing necessity, as convenient access to healthcare continues to become more & most problematic. After all, as they say: “Your health is your greatest wealth.”