Amazon, Berkshire Hathaway and JPMorgan Chase are going to create an independent health care system. This sounds good and they have a lot of power, which will be needed to fight off the insurance companies. I am all in on this if it lets the free market work. This NY Times article gives some of their predictions on how it may happen but who the hell knows? The last point in the article is key, however. It talks about Direct Primary Care:
Doctor as Independent Advocate
“You can imagine them using a different sort of model, where everyone gets a concierge to help them with their health care, to have a primary care doctor be an independent advocate that helps patients navigate the system, not as an agent of the hospital where they have to feed the beast. And then if you need lab tests, an M.R.I., an elective service in the hospital, you would have a health savings account and a marketplace with transparent pricing. And then, if something really bad happens — you get leukemia, you get hit by a bus — the high-deductible insurance kicks in. That’s the way the market is moving anyway, so I bet this is where these companies are likely going.”
— Dr. Rushika Fernandopulle, chief executive, Iora Health, Boston
My fear about Iora, though, is that they are a big company hiring doctors to work for them. They are another middleman and not a true DPC where the physician owns his or her practice. Is there a difference? Yup. What was that parable about giving a man a fish versus teaching him how to fish?