OUR POSITION: It will take creative thinking — like the idea put forth by two North Port doctors — for Florida to rise above its poor performance in health care for its neediest residents.
It’s no longer a debate that health care has become very expensive — even for those who make a good living. And, for Florida’s minimum-wage workers and those without full-time jobs, health care is often inaccessible, except through emergency rooms and free clinics.
Imagine for a moment that health care could be as easy as joining a health club or the YMCA. What if you could pay a modest monthly fee and in return have the ability to get a doctor’s appointment whenever needed? And, when you need lab work, you can have that done for about 10 percent of the normal cost.
Too good to be true?
It sounds so. But two North Port physicians have offered up an idea for health service that is so outside the box it just may work.
Drs. Lee Gross and William Crouch came up with the idea of an Epiphany Health plan — which would grow out of their Prime Health of North Port practice. They came up with the plan while considering ideas to prop up independent practices that are struggling to make it in today’s competitive market.
The idea grew out of a discussion with a local employer who, seeking a way to lower his insurance costs, offered to pay the doctors directly for employees’ health care.
The doctors came up with an idea to contract with patients and employers to provide primary care for a flat monthly fee.
The fee they came up with is $50 per month for an adult and $25 for a child. Patients must be between 5 and 64 (not eligible for Medicare). And, the treatments would not rule out pre-existing conditions.
For that modest fee, each patient gets 25 visits to the doctor each year. And, for a little more money — $83 per month for one adult, $69 for a spouse, $49 for the first child and $29 for other children — the doctors offer a few more bells and whistles. That would include an annual pap test, prostrate cancer blood test and a wellness lab panel once a year for the whole family.
The plan is similar to others that are showing up nationwide as “concierge” doctoring looks to become a fad for the rich and not-so-rich.
The doctors say they can offer cheaper prices because they have contracted with two national laboratories that allows them to pass on savings of 90 percent or more to patients. And, for example, they can send a patient for a chest X-ray for about “$22. If we need a CAT scan, we can get one for $175…”
According to Dr. Gross, he had a patient with rheumatoid arthritis who was quoted $1,800 for blood work. He was able to send her for the same diagnostics for “about $80.”
The doctors presented their idea to the Health Innovation Subcommittee, chaired by Ken Roberson, R-Punta Gorda, in the Florida Legislature last week. The response was encouraging, they said.
What they need from the Legislature to make it all work is to clarify that direct primary care practices are not health insurance and not regulated as health insurance would be — a simple but important bureaucratic hurdle.
In a state that leads the nation in sign-ups for Obamacare and where 20 percent of its people have no insurance, we believe it will take ideas like this to make a difference.
Kudos to Drs. Gross and Crouch for forward thinking. Our lawmakers should take a hard look at the option.