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Delivering Health
Concierge Medicine Reaches Middle Class

Personal physicians aren’t just for the rich and famous anymore. The Washington Post reports on the new appeal for middle-income earners of so-called concierge medicine, in which patients get personalized and prompt care from a doctor they keep “on retainer” for a monthly or annual fee:

These days, new concierge practices tend to target middle-income earners who could feasibly find room in their budgets for health care that’s billed as more personal, comprehensive and convenient, said Gene Ransom, CEO of MedChi, Maryland’s medical society.

“This isn’t just for rich people anymore,” Ransom said. “We’re seeing more and more docs looking into this as a way to practice, and now more than ever, they’re looking at the middle-income bracket.

Some argue that concierge medicine could help bring healthcare costs down. Some people who use medical retainer agreements have only catastrophic insurance, paying the doctor out-of-pocket or from HSAs. That means doctors don’t have to deal with the administrative costs of taking insurance and can pass those savings along to patients if they choose. In addition, the WaPo article argues that competition among concierge providers will help bring costs down over time.

Even if both of those cost control mechanisms work out, however, there’s still a concern that concierge practices will accept fewer patients overall than traditional practices. If concierge medicine became widespread, that would reduce even further the already dwindling supply of health care providers. But if anything this gives us yet another argument for freeing up artificial restrictions keeping the provider corps small—from immigration rules to limits on how much care nurse practitioners can give.

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  • Alex K.

    Isn’t that a return to the old family doctor tradition by those who can afford it?

  • Boritz

    “Some people who use medical retainer agreements have only catastrophic insurance, paying the doctor out-of-pocket or from HSAs.”

    Aren’t these people now required to be covered by an acceptable plan? I thought catastrophic coverage was pretty much off the table. Why is this being written as if it’s some wave of a future in which people have choices and a practical ability to taylor their healthcare for their own benefit?

  • FriendlyGoat

    1) I have to agree that anything we can do to let nurse practitioners have more freedom to do most anything a family-practice doctor can do, the better. Also, any other ideas for letting people with less-than-10-year medical training actually see patients, the better for both accessibility and cost control. We need more professionals and slightly-lesser professionals available, period.

    2) There is something that doesn’t really smell right about having to pay in advance to assure that you can see a doctor. I don’t blame people with money for wanting to pre-buy a service, and I don’t blame doctors for preferring patients they “like” (with a smoothed-out cash flow), but a whole bunch of this concierge business is basically class separation. Public policy ought to not “encourage” it

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