Citing insurance regulations and Medicare changes that make it impossible for doctors to give patients the best individual care possible, Michael Ciampi, M.D., of South Portland, Maine, decided to turn to the free market and get back to a patient-first method of medical care.
As of this spring, the Ciampi Family Practice announced that it would no longer accept private insurance or government Medicare for its services. Instead, the healthcare provider would operate as a cash-only clinic.
“I went into medicine, particularly family practice to take care of people. Insurance regulations and ever changing Medicare laws are interfering with my ability to do this,” Ciampi explains on his website. “Also, the amount of paperwork I need to complete and new rules and regulations I need to learn and follow are now dominating the time and energy which I would prefer to spend with patients. The consequences for not obeying these rules and laws is substantial and could involve enormous fines, or time served in a prison.”
The doctor contends that government meddling has driven up healthcare costs, having an inflationary effect that is threatening patient health and doctors’ ability to keep clinic doors open in the United States.
“Because of the way the insurance companies and the government have interfered with the pricing of medical services, the prices have become overly inflated. It created a system where doctors were forced to charge far more than they ever expected to receive. Part of the bill goes to offset the administrative costs of cooperating with insurance companies, and allow for mandatory write off amounts,” Ciampi says. “By cutting out the middlemen, we cut out a lot of confusion, time, and overhead. If we know that we will actually be paid what we charge (like a plumber, bricklayer, or hairdresser), we can cut our rates dramatically.”
And judging by the price list for services on the practices’ website, the doctor is offering patients a value for his services, ranging from a $50 bill for a simple office visit for a cold or sinus infection to $250 for minor surgeries that may require stitches.
Ciampi says his colleagues in the healthcare business are handling what is observed as a nearly universal uncertainty about the future of American medicine in different ways. Some owners of smaller practices are selling out to larger healthcare providers, and some have opted to wait out the coming changes before making any drastic changes to the way they do business. But he believes other small practices will be looking to doctors attempting direct pay operations.
“Charging people what we feel are reasonable rates and working for them directly fits best with our values. We do not expect to get rich. We would like to survive and thrive. The direct pay model has been working well in other parts of the country,” he says on his website. “It should work well in Maine also. Many of the other solo physicians in our area will be watching us. They may make the same change that we are now if we are successful. “
And Ciampi is right. The impending Obamacare changes seem to have sparked a sort of revolt with healthcare practices similar to his all over the United States.
Ryan Neuhofel, D.O., based in the college town of Lawrence, Kansas, also runs a direct pay clinic and similarly offers a straightforward menu of services and prices online. His patients sign up for a membership with the clinic — which costs $10 a month for people under 29, $20 for over 30, and $50 for families of up to six people — and are then able to receive a handful of free health services and a gamut of for-payment treatments.
And last month, Reason reported that similar healthcare providers are getting started throughout the Nation:
This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model.
The growing number of healthcare providers shunning traditional insurance coincides directly with government’s increasing hand in medicine, and for good reason. As Senator Rand Paul (R-Ky.), who has his own roots in medicine, pointed out earlier this month to the Iowa Republican Party: 122,000 new medical diagnostic codes doctors will have to use in order to inform the government about injuries are being perfected. The codes include line-items for “injuries sustained from a turtle,” “walking into a lamppost” and “injuries sustained from burning water skis.”
“Included among these codes will be 312 new codes for injuries from animals; 72 new codes for injuries just from birds; 9 new codes for ‘injuries from the macaw.’” Paul said on May 10.
“The macaw?” he went on. “I’ve asked physicians all over the country, ‘Have you ever seen an injury from a macaw?”‘
It is certainly safe to say that none of the direct pay clinics researched in the writing of this article offered a price for treatment of flaming ski injuries or parrot attacks.