Why in the World World Would I Pay TWICE for Healthcare?

Photo by Brian Jackson/iStock / Getty Images
Photo by Brian Jackson/iStock / Getty Images

On Sunday, November 1st, LNP (the local newspaper of Lancaster, PA) published this article about CovenantMD, and on November 3rd, Fox 43 featured this segment.  I think it's fair to say that these caused a local social media sensation.  As a result, I’ve been crisscrossing Lancaster County holding free presentations about Direct Primary Care and CovenantMD for families and businesses.  

I enjoyed sifting through all the comments (I even responded to quite a few).  It was fun to read the many cyber high fives.  It was also great to read comments from some that had reservations about Direct Primary Care.  In thanks to those people that carefully read the article, considered it, and posted their reservations, I offer this post.  Here, I will address what by far was the most frequent objection to the concept of DPC, and that is “Why in the world would anyone pay twice for healthcare?”  I’ll also address a frequent misunderstanding that went hand in hand with this objection, and that is “This model will only work for the rich people that can afford to pay monthly DPC fees.” 

Need a quick refresher on what Direct Primary Care is?  See my first blog post.

So onto the “pay twice” objection.  What people mean when they ask this question is why would they pay once when they pay their health insurance premiums, and then again when they pay the monthly Direct Primary Care fee?  My reply is that when you have health insurance, you are already paying twice.  The first time you pay is when you (or your employer, or the government) pay your premiums, and the second time is when you pay anything in addition to those premiums, like copays, prescriptions, etc.  Direct Primary Care is a way to decrease how much you shell out for the second payment, while providing high quality, easily accessible primary care to boot.  Actually, it is a way to save money on the first payment, too.  You can think of DPC as “carving out” the primary care piece from health insurance.  With DPC, people can consider transitioning to a lower premium, higher deductible insurance plan, carrying DPC as a hedge against using their deductible.  Health insurance is then reserved for the less common, expensive stuff.  Isn’t that how car insurance works?

Allow me to illustrate this with a real life example.  A friend of mine was jogging one day recently, and he cut his leg while trying to hop over a guardrail to avoid a deep puddle.  He went to the ER.  The ER doc did a skillful job stitching up the wound, and the insurance company, a few weeks later, did a skillful job of handing him a bill for $1800!   (Alas, he had a high deductible.)  My friend had no way to predict, nor to control, the costs adding up as his leg was being mended in the ER.  In CovenantMD, the total bill for the procedure would have been $70 paid at the time of service, a price he would know before hand, as he would have already known that it costs $50 for me to come in after hours, and another $20 to do stitches.  That is a difference of $1730.  That’s $1730 saved on the “second payment” I mentioned above, which just more than paid for CovenantMD memberships for his entire family of five for a year!

Now with that in mind, you can probably answer for yourself the misunderstanding that Direct Primary Care is a program for the rich.  In fact, it’s the opposite.  Direct Primary Care is a great way for low to middle income people, and the uninsured, to access high quality primary care without the long wait and treadmill culture of traditional doctor’s offices, all while reducing costs.

Interested in finding out more about Direct Primary Care and CovenantMD?  I would love to tell you more in person!  Set up a free information session by giving me a ring at 717-287-1983, emailing me at pmr@covenantmd.net, or visiting our website, www.covenantmd.net.

Patrick Rohal, M.D. is a family doctor and the founder of CovenantMD.  He lives in Landisville, PA with his wife, Lynn, and three children.