Re: Your August 3 Health Care News article “Physicians Flock to Summit on Innovative Direct Primary Care”: Thank you for a great article on direct primary care (DPC). Although the article distinguished insurance companies from health care sharing ministries (HCSMs), which are not insurers, communicating this distinction is an important ongoing process.
The article mentioned Liberty Direct, a product offered by the HCSM Liberty Healthshare that is compatible with some DPC memberships. We at Liberty Healthshare see DPC as not only an opportunity to bring patients back into a caring relationship with their physician, but also to align the incentives of physician and patient, so that they are both focused on maximal quality for the most appropriate cost.
Insurance Is Dysfunctional
To reiterate, Liberty Healthshare is not insurance; it is a health care sharing ministry, which is an exemption from the mandates of the Affordable Care Act (ACA). Insurance companies have long been inserted into the doctor-patient relationship. That type of third-party payment scheme has taken away the immediate financial impacts from the patients of their medical decision making, while burdening everyone with the adverse financial and social effects of the resulting price hyperinflation. We know that the insured patient has less incentive to care about price, and as a direct result, the prices of health care rise, and indeed do so exorbitantly.
The purveyors of health insurance and government programs realized too slowly that in implementing the costly ACA, they have been hoist by their own petard. They then doubled down on their mistakes by imposing all those things the DPC movement rightfully disdains, such as price controls, bureaucratic barriers to accessing care, external interference, prodding, and threats. Health insurance—initially subsidized by and now mandated by the government—is dysfunctional.
The Freedom of Sharing
Liberty Healthshare is not part of that insurance paradigm. Indeed, it is very important to reiterate that Liberty Healthshare is not insurance at all. Rather, Liberty Healthshare is a voluntary community of people who have agreed to share in the financial burdens that the insurance paradigm has unfortunately imposed on all Americans.
We who have joined Liberty Healthshare are driven by empathy for those who have the misfortune of being ill, and who also must deal with the financial injury caused by the hyperinflated prices of medical care. Liberty Healthshare’s primary administrative role is to use modern technology to help our members share their resources with other members in need. We share in burdens, as well as sharing beliefs and optimism.
Because Liberty Healthshare members also recognize the negative impacts that any third-party payment scheme can cause to medial economics, we also seek to support novel and ancient concepts of health care delivery that have financial and health incentives well aligned, and that place both financial and health decisions into the hands of the physicians and their patients.
Sharing Meets Direct Primary Care
Liberty Healthshare is encouraging our members to consider the direct primary care model, because DPC physicians and patients together provide a grassroots method of stewarding (i.e., caring about) the resources of our membership as a whole, as well as the resources of the individual patient/member of the DPC practice. DPC treats patients and physicians as adult moral agents—fully capable of determining right from wrong. This is consistent with the philosophy that a conscientious Liberty Healthshare member holds.
We are continuing to pilot our Liberty Direct DPC program and improve it—based on valued feedback—to assure our own program doesn’t misalign incentives. First and foremost, our Liberty Direct members are sharing members of Liberty Healthshare, with all the responsibilities to be good stewards of the membership’s resources that come with being a Liberty Healthshare member. Secondly, Liberty Direct members are Liberty Healthshare members who have voluntary joined a DPC practice.
We appreciate their efforts to steward the resources of the membership by doing so. They help us all learn how the moral philosophies of a voluntary sharing mentality can merge with the DPC movement’s valuable efforts to return both health and financial decisions into the hands of the patients and their chosen health care professional.
Thank you for an insightful article.
John Hunt, MD
Chief Medical Officer, Liberty Healthshare
Image via Thinkstock