Despite much talk about a very real — and growing — problem with access to primary-care physicians as older doctors leave the profession and the ranks of new providers thin out, there's still hope for Americans who don't want to wait in line for medical care. There's hope, that is, for people willing to pay cash on the barrelhead for services rendered. That's because the numbers of doctors refusing third-party payment and insisting on dealing directly with their patients as customers is steadily growing. The change not only frees doctors and patients from bureaucracy, it reduces much of the pressure driving increases in healthcare costs.
Obamacare’s most intrusive changes to the healthcare marketplace — including the individual mandate whereby Americans must secure health insurance or pay a fine and its massive expansion of Medicaid — are less than a year from taking effect.
Many doctors have decided that they’re not interested in seeing how those changes play out in their own practices. Nearly two-thirds of doctors say that they or their colleagues will retire earlier than planned over the next few years, according to a survey conducted by consulting firm Deloitte.
Others are considering a departure from the current system of third-party payment. Instead, they’re exploring direct payment, with patients paying for care on their own.
Patients should welcome this development. Not only does the move toward direct payment have the potential to reduce health costs — it could also yield higher-quality care.
Even before Obamacare, direct-pay practices were growing in popularity. According to the Center for Studying Health System Change, direct-payment practices increased from 9.2 percent of the market in 2001 to 12.4 percent by 2008.
Nearly 7 percent of doctors say they are planning to change to some form of direct-pay care in the next three years, according to a survey of 13,000 doctors done for the Physicians Foundation. The consulting firm Accenture projects that one in three doctors in independent practice will adopt “subscription-based care models.”
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