Wisconsin State Rep. Prepares Direct Primary Care Bill

Published November 30, 2017

Wisconsin state Rep. Joe Sanfelippo (R-New Berlin) is seeking cosponsors for a bill that would allow health care providers and patients enrolled in Medicaid to enter into agreements for direct primary care (DPC).

Instead of billing insurance companies or the government for patients’ health care, doctors providing DPC directly enter into agreements with patients, charging a regularly scheduled fee and listing procedure prices up front.

Sanfelippo’s bill would define DPC services as being health care, instead of health insurance, freeing participating primary-care providers from the state’s insurance regulations.

A Free-Market Alternative

Sanfileppo says big-government approaches to health care have failed to help people and it’s time to try something different.

“Co-pays and deductibles have been creeping higher and higher as a result of all the turmoil caused by Obamacare,” Sanfelippo said. “With direct primary care, of course, you pay a monthly fee to a doctor that gives you 24-seven access, and you have no co-pay or deductible. You go in and you don’t have those out-of-pocket costs.”

Patients, Not Paperwork

Sanfileppo says his bill would allow doctors to focus on patients instead of paperwork and billing.

“I like to refer to it as kind of that old-fashioned doctor-patient relationship, where the doctor really has the time to be able to get to know the patient,” Sanfileppo said. “They’re not just running in for seven minutes, doing a quick once-over, and then spending another 20 minutes filling out insurance forms, Medicaid reimbursement codes, and all that other stuff. I think you see just much, much more personalized service.”

Chris Rochester, director of communications at the John K. MacIver Institute for Public Policy, says Sanfelippo’s bill would improve health care by cutting out middlemen.

“This is an innovative way of getting basic medical care by dealing directly with your doctor, bypassing the red tape of an insurance company,” Rochester said. “Often patients will pay a flat monthly fee, like a cable TV subscription, and will be able to see their primary care doctor at little or no charge whenever they want. This arrangement fosters a relationship between the doctor and the patient, an added and important benefit.”

Cutting Costs

Sanfelippo’s bill would use free-market principles to do what Obamacare couldn’t do, Rochester says.

“Importantly, this bill is likely to help bend the cost curve down, which is something the big-government approach, like Obamacare, has failed to accomplish,” Rochester said. “The savings to taxpayers could be in the hundreds of millions of dollars.”

Other Ideas for Reform

There are other ways free-market principles can promote better health care in Wisconsin, Rochester says.

“One area we could improve considerably is in the area of telemedicine,” Rochester said. “As a largely rural state with shortages in many professions, including doctors, telemedicine would help rural patients who live far from medical facilities. Wisconsin could also improve pharmaceutical access by enacting a right-to-try bill, which is working its way through the legislature.”