The California HealthCare Foundation (CHCF) has produced an interactive graphic showing the sources of health care payments in the United States from 1960 to 2011. Particularly striking is the shift in physician and clinical services that comprise much of primary care. In the 1960s, most of these costs were paid directly out of pocket by patients. Beginning in the late 1970s, commercial insurance plans began picking up a larger proportion, reaching a peak of 49 percent in 2005 before declining slightly to 46 percent for 2011, according the CHCF compilation.
Proponents of pre-paid direct primary care contend that covering primary care in the same health plan as high cost catastrophic care such as hospitalization – covered under “major medical” policies in the 1960s — is as nonsensical as using car insurance to cover routine maintenance and oil changes.
The CHCF issued an issue brief on Direct Primary Care Medical Home Plans authored by Dave Chase noting these plans offer significant potential health care cost savings over all inclusive plans such as HMOs while providing economic incentive for primary care physicians – many of whom will be needed to care for new patients obtaining health coverage under the Patient Protection and Affordable Care Act.
Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email