Andrea Meneses has stumbled Direct primary clinic For crisis.
Her grandmother, who visited Wisconsin from Bolivia, had no insurance, but had to fast. One of his grandchildren accidentally put insulin in the freezer instead of the refrigerator.
Menesses contacted a friend in panic, and one recommended Dr. Wendy Maska. Direct primary care A nearby Madison clinic. Patients in these clinics pay for about 50 to 100 months and can easily access doctors directly.
Directly primary care is an increasingly popular healthcare option, and experts may become more common under the change of health policy expected by President Donald Trump's administration. I say. Robert F. Kennedy Jr.Trump candidates, led by the Ministry of Health and Welfare, mentioned primary care directly at recent confirmation hearing.
“This is the most optimistic I have been so far,” said Gale Breque, a health service researcher based in Kansas City, Missouri, has been studying primary care directly for over 10 years. Ta. “We are in the thrills that can really take off.”
Some doctors and patients love how easy it is to receive daily medical care and how some services are cheaper. However, public health experts should be careful not to directly consider primary care as an alternative. insuranceThis is because the monthly fee does not cover anything other than visiting.
Quick care at an affordable price
Directly main patients are not particularly health insurance, and otherwise they say that they can save a considerable amount of medical care for those who pay from pockets.
Musca did not have insulin in her office, so she introduced her prescription to a community pharmacy working with her, and the pharmacist helped Menes to secure it at a discount.
Brekke stated that a directly primary care doctor would also work with the labs and imaging centers to order patient tests and X -rays at a discounted price. In most states, most of these doctors can distribute drugs to medical treatments with or completely marked up. Otherwise, doctors like Maska are often related to local pharmacists and can help patients take medicine at a more affordable price.
MOLASKA receives an individual claim from $ 70 to $ 85, and keeps the monthly fee of $ 200. In Central Wisconsin, she has a bilingal staff, watching Spanish and English speaking. MOLASKA has 125 waiting lists.
After seeing how well the model works for grandmother's needs, all Menesses's family is now a Maska patient. Menesses said that her child's medicine was cheap, and they don't have to wait three months to make a reservation.
Next, direct primary care doctors say that they can spend more time with patients, and they do not need to deal with insurance companies, reducing their burning syndrome.
“I wish more people knew it,” said Menesses. “I'm an accountant, and the clients are mostly hiss breads. Most of them are not qualified to help and can't afford to buy healthcare, so I send them to Dr. Maska. Sometimes they are. Ask me, “Isn't this a scam?”
It's not for everyone
Critics believe that direct primary care is a solution of a group of limited people: relatively healthy groups, people who have no room for insurance, who are not qualified for medicare, and community health centers For new patients living in an area that is too busy.
Health researchers also warn you to exaggerate the direct primary prices of primary care.
“I worked on a safety net health system for most of my career, so I found that many patients were having a hard time paying a bus fare or $ 5.”
Dr. Kevin Schulman, Stanford's Clinical Excellence Research Center, said that direct primary care was “better than nothing,” but very limited. Since direct primary care is not health insurance, nothing is covered, except that doctors can take office.
Dr. James Vandalou says that direct primary care is the best way to catch the collapsed people “through cracks.”
Vandarou is practicing several miles north north of Jackson, Mississippi. This is one of the poorest states in the United States, where lawmakers are not expanding Medicade. Therefore, residents in Mississippi, who may have no children, regardless of their income, are not qualified as a federal insurance program for low -income earners. Dollar.
Mississippi is also ranked up or near the percentage of diabetes and high blood pressure. This is a type of chronic disease that Vandalou is useful for frequent testing and drugs.
“There is no way to take out the worm, but if you have diabetes, you can get an A1C test of $ 10 or less,” he said, and he measured blood sugar and used to manage and diagnose diabetes. I talked about. “You need some kind of help to lift a heavy lifting, but it's better than nothing.”
However, if hypertension causes stroke symptoms, one of Vandarou's patients must go to the emergency treatment room.
Poor insurance person in charge
Florida -based provider Lee Gross began practicing primary care directly in 2010 and became one of the first waves of direct primary clinics nationwide. He was angry with the insurance company and wanted a way to help patients without an intermediary.
Annie Geisel has been practicing gloss in a no -sport on the Gulf of Florida since 1998. Later, Gross moved directly to the primary orike clinic. After the switch, Gaisel was surprised at the speed of seeing the lack of total collection and joint payment, but her friend complained that the insurance company was delaying their care.
“I think it's time for doctors to start calling shots on patient care, not insurance conglomerate,” said Gionel, mentioning the insurance company process that allowed patient care.
Increased disillusionment with traditional health insurance -Lobby activities continue in the industry, as proved by the wave of criticism of the people UNITEDHEALTHCARE CEO assassination -You can make direct primary care a more attractive model.
Project 2025, the conservative policy blue photo of the Heritage Foundation calls primary care from the second Trump administration as a solution. Roger Severino, a lawyer and former director of the Civil Rights Bureau in the Trump administration, wrote that the model “improves access to patients, promotes higher quality and cost, and strengthens the relationship between doctors and patients.” I am.
Sureman said that his administration tried in 2019 but could not be determined under former President Joe Biden, which could refer to Trump's efforts to change access. 。
If Trump and Republican Party manages the lower house and the Senate, if people continue to have the potential reduction of Medicade, which may be difficult for people to qualify for programs, direct primary care may be more relevant. there is.
“I consider direct primary care as a kind of lifeboat in the system. It's for the crack of the system,” Glos said. “And we are growing and filling these gaps nationwide.”
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