Health Care

The Direct Primary Care Solution for America’s Health Care Woes

(Unsplash)
It could free us from insurance domination of health care.

Austin — “the live music capital of the world” — is a lovably “weird” city and home to many musicians and artists. Willie Nelson, Stevie Ray Vaughan, Townes Van Zandt, and Janis Joplin all called it home at one time or another. Great venues like Antone’s, the Broken Spoke, and Stubb’s kept the music scene alive for years, and as it continues to evolve, they serve as storied reminders of what has always made Austin great — a vibrant arts scene.

When I was in law school at the University of Texas, I remember rushing to buy the 2-CD KHYI set each year for the best music of the day. But I also recall that the proceeds from the sale of the set went to providing health insurance for artists. This was a way people in the arts community looked after one another.

Unfortunately, while the creative community remains alive in Austin, the rising cost of housing, driven both by demand and by property taxes, and the skyrocketing cost of health care are crushing many of the artists who live gig to gig and paycheck to paycheck. Since 2013, insurance premiums have gone up more than 60 percent across the board, while private-market premiums have doubled and even tripled. While Washington “leaders” dither and waste time, some creative doctors are using a fast-growing direct-primary-care (DPC) model that may well save the day.

“METSI Care,” a recently opened DPC clinic on 6th Street in East Austin, is built on the model of the black-bag doctor. In this model, you pay a doctor for health care at a reasonable monthly fee and the doctor provides the services directly, rather than insurance (or government) bureaucrats telling you what you get, or what’s “in network.” The two doctors running METSI when I visited are focusing their care — in part based on personal interest and passion — on those in the music, entertainment, technology, and service industries. While they are targeting artists, it is important to note their doors are open to all who knock.

In my view, DPC and related policies that support it are the future of health care. For too long, we have allowed insurance companies to run the system, driving doctors out of the business. Doctors are experiencing burnout at an incredible pace. According to a recent survey, half of doctors experiencing burnout blame “too many bureaucratic tasks” as a main reason. Indeed, the two doctors of METSI viewed DPC as their own personal lifeline to staying in medicine without spending most of their time filling out paperwork and responding to insurance companies and government.

DPC will expand coverage by lowering prices and restoring the doctor–patient relationship. This issue matters a great deal to me. As a cancer survivor, I am a walking, talking, preexisting condition. But in truth, we all are! Many Americans are hanging on to their jobs — whether they like the job or not — to keep their health insurance. Even when it’s expensive, with a massive deductible providing the “luxury” of only a few in-network doctors miles away, and you still get to spend $300 on insulin.

While many Democrats run on a budget-busting and highly regulated Medicare for all, the truth is that for more than 40 years both Republicans and Democrats have empowered insurance companies while regulating them in a crony-capitalistic failure that has resulted in higher-priced care and higher-priced insurance stocks.

I’ve been working to expand access to health savings accounts (HSAs) and broaden access to DPC, health-care-sharing ministries, and other unique solutions. We need to look beyond the status quo health-care system and bolster the solutions that often get lost in the noise of Capitol Hill.

Direct models like those of METSI in Austin are the core of the solution. While I may agree that DPC is not the full fix, it is the first step in the right direction. Roughly 80 percent of the health care an individual requires is primary care. DPC can solve most of our health-care woes. If government leaders do their jobs, insurance can start acting like insurance again — protecting us from the “big stuff” instead of preventing us from getting access to care in the name of coverage.

Passion and thinking outside the box are what make Austin great. One day, they’ll make health care great too.

Chip Roy serves as the U.S. representative for Texass 21st congressional district.

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