As
a Direct Primary Care physician in Greeneville, Tennessee, who has not accepted
health insurance for over 18 years, I have been in a unique
position to see how insurance for nonemergency outpatient medical care not only
increases our country’s debt but also how it stifles our overall economy
leading to reduced tax revenues from which to resolve this debt.
Americans carry insurance for unexpected catastrophes such as car
accidents, burned houses, and inpatient hospital care. We don’t purchase it for
routine car or home maintenance, so why do we have it for everyday medical
care? The reason is, unlike other insurance, it is a pre-tax expense enjoyed
primarily by large and medium-sized corporations that exert a large amount of
political influence.
Most people don’t know that this tax exemption for employer-provided
health insurance adds about $350 billion to our national debt each year while
discriminating against the self-employed and employees of small businesses,
many of whom can’t afford health insurance yet were cruelly forced to pay
ObamaCare penalties. The increasing number of families
choosing membership in Christian health care sharing ministries don’t benefit
from this tax exemption. As a matter of justice both to future generations who
will be responsible for this debt and to the many uninsured, Congress
should eliminate this tax favor. While they are at it, Congress should remove
the tangle of insurance regulations so companies will have to compete by
offering consumers the opportunity to buy policies that make sense.
When Americans pay directly for outpatient medical care at
facilities that make their pricing transparent, they pay much less than they
would at facilities that don’t.
Doing so -- I estimate -- would return to the economy as much as
$1 trillion a year, mainly because insurance for routine health care makes it
easier to conceal and inflate prices while charging for services that patients
wouldn’t necessarily allow to be done if they knew ahead of time that they
would have to pay for them with their own money.
I have observed that patients and health care providers today
don’t seem to know what -- or even if -- insurance will pay for elective
outpatient care. My Direct Primary Care patients who pay me directly are not
confused by such uncertainty. They make me cost-justify diagnostic strategies
and therapeutic interventions before they are undertaken. As a result, lab
tests purchased at my clinic to evaluate fatigue cost about $500 less than what
insured patients have told me they have had to pay other providers after
receiving bills from them in the mail for amounts not covered by their insurance.
My uninsured and high-deductible insured patients regularly drive
to private, for-profit facilities in nearby towns and cities to save around
$100 on X-rays, several hundred dollars on ultrasounds and cardiac stress
tests, over a thousand dollars on CT and MRI scans, and several thousand
dollars on colonoscopies. One patient traveled 900 miles to save more than
$10,000 on outpatient surgery at the Surgery Center of Oklahoma, which posts all-inclusive
prices on its website and offers patients a way to pay for such procedures on
credit.
These examples show that
when Americans pay directly for outpatient medical care at facilities that make
their pricing transparent, they pay much less than they would at facilities
that don’t.
Since Direct Primary Care practices such as mine don’t bill
insurance, we require three fewer employees per physician than those that do.
That means that, with roughly 350,000 primary care physicians in this country,
health insurance drains approximately 1 million dependable, hard-working
persons from our labor force when there is less than 4 percent unemployment.
Many jobs that are unfilled as a result are arguably of greater service to our
fellow citizens than the settling of small medical claims that require a
ridiculous and onerous level of documentation in electronic medical records .
So, from my perspective,
simply eliminating the tax exemption for employer-provided health insurance
would bolster the economy by reducing health care costs and supplying
much-needed labor to our nation’s employers while leveling the tax playing
field for all Americans. Most importantly, it would help to reduce our national
debt and preserve our legacy of freedom for generations to come.
Samaritan Ministries International member Dr. Robert
Berry practices medicine in Greeneville, Tennessee. He ran an insurance-free
fee-for-service practice for 18 years before transitioning it in January 2019
to a Direct Primary Care named DirectMD Greeneville.
To read an interview with Dr. Berry, visit SamaritanMinistries.org/drberry.