SHARYL ATTKISSON As a patient, you usually have to take whatever tests or treatments the doctor orders... and pay whatever he charges. Who would put up with that if you were shopping for a car or a computer and the salesperson dictated what model you'd buy regardless of whether you liked it or how much it cost? HealthWeek's Andrew Holtz looks at a whole new approach in health care where the consumer is king.
WAITRESS: "Hi, I'm Ann. Can I get you anything to get started?"
ANDREW HOLTZ: "Anything you recommend?"
WAITRESS: "Sure, blood draw for $5. I also have a cholesterol test for $7.70, and also a full lipid profile for $30.80."
ANDREW HOLTZ: "Well, I'll tell you, my stomach's been kinda acting up lately. Anything to check for ulcers?"
WAITRESS: "I have an H. Pylori test for $29.40."
ANDREW HOLTZ: "Oh, that sounds good."
Actually it sounds strange, doesn't it, trying to order medical care off a menu? Well actually you can, through a new approach called Simple Care: it's a back-to-basics way of cutting out insurance and keeping all the money going towards medicine.
Dr. David MacDonald helped create simple care two years ago. It's a system he uses in his Renton, Washington clinic.
Patients choose the tests they want, and agree to pay in full before they leave. In return, they get cut rates... as low as $35 for a short office visit. And Dr. MacDonald trims his paperwork headaches.
"And this is all the paper that you wish you didn't have?"
DAVID MacDONALD, MD, SIMPLECARE CREATOR: "This is the headache, this is what takes time away from the patient, this is what adds expense to each visit, this is what we think could be changed dramatically."
ANDREW HOLTZ: Getting around the paper mountains of managed care saves the doctors time, and money, both of which are directly passed on to the patient.
DAVID MacDONALD, MD: I would say we probably can spend 10 to 15 minutes more per patient in a Simple Care setting, than in a traditional insurance setting."
ANDREW HOLTZ: Susan Anderson has asthma, and two young children. Neither her job nor her husband's provides health insurance. They had been paying for their own coverage, until their premiums doubled.
SUSAN ANDERSON: "We couldn't afford over $600 a month for insurance, so we dropped that. And the doctor told us about the Simple Care, which has just been great."
ANDREW HOLTZ: Dr. MacDonald says his first goal was to help patients like Susan, who have no insurance, but he thinks everyone can benefit from the "simple care" approach, for routine visits and treatment. He says most patients know what they need.
DAVID MacDONALD, MD: "They come in well armed, with not only information, but goals, expectations."
ANDREW HOLTZ: When they don't, he advises them on the care they should have.
"What about preventive care? Say, the PSA test for prostate cancer, or cholesterol where patients don't feel sick; is there any concern that they might skimp on preventive testing?""
DAVID MacDONALD, MD: "Actually, in our experience, the opposite is true. If we tell people that a test is needed to check their cholesterol and to check their blood sugar, they do that."
LAURA: "Hi, this is Laura calling from Primary Care Providers in Renton..."
ANDREW HOLTZ: Dr. MacDonald says he's cut in half the number of staff needed to handle billing and referrals to specialists. He says the savings they've seen are prompting doctors around the country to adopt "simple care"or their own version of cash discounts.
DAVID MacDONALD, MD: "This paperwork is it, there's just one simple piece of paper, and we're done."
ANDREW HOLTZ: And it's all being done in the hope that, with a "menu" of services, and without insurance paperwork, "simple care" can offer medical care that's just what the patient ordered.
SHARYL ATTKISSON: Simple Care's cash-only system may be fine for routine medical problems. But what if you're hurt in an accident or come down with a major illness, like cancer? For those situations, most Simple Care patients still need insurance.
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