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Doctors seek to cut out insurance companies


(Image courtesy Pixabay)

America’s health-care system would benefit from giving patients more choices, according to a coalition of physicians.

Removing restrictions on programs that cut out the middle-men, the insurance companies, would be one positive step, contends the American Association of Physicians and Surgeons.

One effective program, called Direct Primary Care program, has patients pay a set fee, between $40 and $100, to physicians for primary care services, some lab tests and some pharmaceuticals.

AAPS submitted comments to the Internal Revenue Service regarding a plan to allow employer-funded Health Reimbursement Arrangements to pay premiums for Obamacare-qualified individual plans.

To the extent that they increase patient options, “it is a step in the right direction,” AAPS said.

But the IRS needs to address restrictions on the use of HRAs for Direct Primary Care plans.

“DPC is an increasingly popular model where patients cut out the insurance middlemen and pay a low monthly subscription fee (often between $40 and $100) to their doctor. The fee often covers all primary care services, certain laboratory tests, and at-cost pharmaceuticals that may cost 15 times more at the pharmacy,” the association explained.

“Current IRS guidance is improperly blocking patient use of HRA and Health Savings Account (HSA) funds for these innovative arrangements. Patients are even prohibited from contributing to their HSA if they pay a monthly fee to a DPC practice,” the physicians said.

“The Trump administration’s ‘Reforming America’s Healthcare System through Choice and Competition’ report recognizes that inserting middlemen in between patients and their physicians ‘has contributed to a system that produces high costs with uneven quality,'” they said. “DPC is a proven solution to achieve the report’s call to ‘reconnect patients more directly with those caring for them,’ while lowering costs and increasing quality.”

A good solution would be for the IRS to follow the administration’s lead on the issue, they said.

“Existing authority from Congress allows the IRS to resolve this problem in the upcoming final rule. The Docs 4 Patient Care Foundation submitted a legal argument that effectively lays the foundation for the government’s ability to cut through the red tape hindering cooperation between DPC and account-based solutions, like HRAs and HSAs, without any additional legislative action,” AAPS said.