Dr. Michael Ciampi of South Portland, Maine, might do more to reform health care than the entire Obama administration. On April 1, Ciampi decided to stop taking insurance at his primary care practice, charging people instead a fixed, out-of-pocket price for all services. By cutting out the insurance middlemen on all claims, Ciampi will save both himself and his customers time and money. Bangor Daily News:
Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50, he said.Ciampi collects payment at the end of the visit, freeing him of the time and costs associated with sending bills, he said.That time is crucial to Ciampi. When his patients come to his office, they see him, not a physician’s assistant or a nurse practitioner, he said.
Ciampi made the switch in April, but it is just now starting to get a lot of attention. After the Bangor Daily News piece came out, the story got picked up nationally, and has now been linked to on both Drudge and Gawker.The attention this story is getting is very good news. We have highlighted similar attempts by doctors to replace insurance with new payment mechanisms. Changing the perverse incentives currently driving up health care costs is a key priority for true health care reform. One way of doing this is to de-emphasize the role comprehensive insurance plays in the system, whether by using catastrophic or high-deductible plans more widely or even by more radical reforms, like Ciampi’s business model.Ciampi-like models have already been gaining steam, but wider press coverage of this option will help raise national awareness of new kinds of payment mechanisms. We’ve become so used to the way we use health “insurance” that we’ve lost the ability to think about alternatives. Obamacare, whatever its merits, mostly just doubled down on our current system.Any attempt to push the Ciampi model on the nation through federally mandated reforms would be the wrong way to go, but as more doctors experiment with similar models, and the press continues to cover it, patients and providers across the country might start voluntary shifting away from comprehensive insurance. A bottom-up movement like that could to do more to reform our system than thousands of pages of Obamacare laws and regulations. Ciampi and others deserve credit for testing new approaches on a micro scale.