Republican candidate for Governor Lora Hubbel sends out an e-mail that reiterates her standard charge that her primary opponent, Governor Dennis Daugaard, has facilitated the implementation of the Affordable Care Act in South Dakota. Hubbel says that if you'll make her Governor, she will implement a health care reform plan that will kill the ACA in months:
We can make ObamaCare dry up and blow away. Doctors and patients will love the plan I've found. But the uber-rich politicians and big healthcare business in South Dakota won't because they will lose money.
Imagine going to a Doctor and being able to pay for the visit and treatment without breaking the bank. Imagine no insurance claims and codes...doctors can treat you without looking at a computer.
Imagine no government paper work for the doctor and none of your personal information going in government data banks like it does now. Instead computers would be used by the patient to look up the prices of all doctors and treatment available... no limits on which doctor you can see.
This is the brainchild of Dr Merlin Brown, Cardiologist in Minnesota. He has developed a health delivery system that is truly patient/doctor controlled and big government and big hospitals/Big managed care hate it. However doctors, patients and private Insurance companies love it. If we get it going it can be up and running in 6 months...it's already developed [Lora Hubbel, campaign e-mail, 2014.05.11].
Instead of telling me what her plan is, Hubbel then veers off into bashing Daugaard, Mike Rounds, and "blog-dogs" who call her crazy because they "can not refute my research...." I'm thus left with a campaign pitch that sounds more like an Amway recruitment pitch than a serious policy proposal.
But that's what the Googles are for. Melvin Brown, cardiologist, health delivery system... ah ha! Concierge care. Dr. Brown and his colleagues at Southdale Internal Medicine in Edina don't accept private insurance. Southdale posts its prices online. Patients can pay fees for specific services, or they can buy into a "Total Care" plan: $118 per month for the first family member and $68 per month for each additional family member covers all in-clinic services. $1,416 for an individual is well below the $3,300 limit for tax-deductible individual Health Savings Accounts. A worker could get full service for herself and up to seven family members under the $6,550 limit for a multi-user HSA.
Dr. Brown is doing what we discussed here in a follow-up to my conversation with Independent gubernatorial candidate Mike Myers: price transparency and direct-to-consumer pricing.
Of course, concierge care doesn't de-implement the Affordable Care Act. Concierge care simplifies business for primary care providers. Concierge care could save patients money, but they'll have to do some figuring:
- If I pay up front for concierge care, will my insurance company reimburse me?
- If not, can I cover the cost of the concierge care plan with the savings from choosing a higher-deductible insurance plan?
- Do I qualify for an hardship exemption from the ACA insurance mandate so I can just buy a catastrophic health insurance plan to cover the really big procedures that concierge care doesn't provide?
- Is it cheaper for me to pay for concierge care to get my check-ups and other primary care, go without insurance, pay the ACA penalty, and hope to heck cancer or a dump truck doesn't get me? (You should really try not to get to #4.)
As far as I can tell, there is nothing stopping South Dakota clinics from adopting concierge care. One of Annette Bosworth's employees developed a concierge care plan for Bosworth's clinic last fall. Successful implementation of the plan at Meaningful Medicine was stopped not by state law or the "entrenched powers" but by the distraction of a fake Senate campaign, Bosworth's general inability to organize, and Bosworth's failure to pay her employee to implement the plan.
Lora Hubbel leaves me wondering just what role there is for a Governor to implement concierge care beyond bully-pulpitism. Hubbel would have the chance to present that role in her debate with Governor Daugaard and for us to hear the Governor weigh on alternatives to private insurance... but oh, that's right, the Governor declined SDPB's invitation to a May 22 debate, and SDPB declined to seek an alternative date. (Boo on DD and SDPB!)
Luckily, Lora Hubbel will have an opportunity to elaborate on concierge care and other policy issues right here on the Madville Times. Hubbel has agreed to appear in a live online interview on this blog on Wednesday, May 14, at 9 p.m. Central, 8 p.m. Mountain. Stay tuned for more details, and send your questions about health care and other issues!