Peter Suderman on Supply Side Health Care Reform

Could the Netflix model work in health care? A doctor's office in Rochester, New York is aiming to find out. Good MD, a primary care office set up this year, charges patients a single, flat monthly fee for unlimited visits. Monthly charges are based on age, and extra services—whether stitches or strep throat tests—are provided for an additional fee, posted online and in the office. The practice doesn't accept private insurance at all.

The result is a system that benefits not third-party payers, but doctors and patients, Good MD Founder Dr. Thuc Huynh, told local TV station WROC. "Insurance isn't who reimburses me or dictates what we do together in terms of our treatment. So, it's a direct financial relationship."

This is what the future of health care reform could look like: It's provider-driven. It's consumer-focused, with an emphasis on both price and service. And it's happening at the margins—at a single practice, in a single town.

As Obamacare's has settled into place, the Republican party's promises to repeal and replace the law have stagnated. The law is still unpopular, but the coverage expansion has made the already difficult prospect of repeal harder than ever, and despite years of promises, no obvious replacement plan has emerged. Obamacare's critics in Congress are still opposed to the law, but increasingly seem unsure about what to do instead.

Senior Editor Peter Suderman writes that provider-driven experiments like what's happening at Good MD could help point to a different way of thinking about the problem.