Monday, February 16, 2009

Knope in Wall Street Journal

The February 14, 2009 Wall Street Journal has a major article on concierge medicine, featuring Dr. Steve Knope. Here's an excerpt:
Health Matters

Dale Haralson was the kind of patient some doctors would rather avoid. In 2005, the Tucson, Ariz., lawyer had a triple-bypass operation, then contracted an infection that spread to his chest, lungs, blood and bone. He needed more surgery and was told he would need a permanent feeding tube. But few surgeons wanted to take his complex case.

A former partner recommended that he see Steven D. Knope, a local primary-care doctor who treats a small group of patients in exchange for an annual fee. Dr. Knope took over Mr. Haralson's care, and found a skilled and willing surgeon and a pulmonologist who said that, instead of a feeding tube, he just needed to use an inhaler every day.

Today, Dr. Knope handles all the routine medical care for Mr. Haralson and his wife, Betty, and tracks the couple's general health and fitness. Together, they pay him $10,000 a year, and think it's money well spent. "All you need is one crisis and a good outcome and you know it's worthwhile," says Mr. Haralson, age 71, who exercises regularly, still practices law and still eats chocolate cake.

The kind of "concierge medicine" that Dr. Knope practices is gaining popularity across the U.S., particularly among older Americans with complex medical needs...
(Read the whole thing.)

In particular, there are a few points worth highlighting.

1) Concierge doctors take care of some complex, challenging patients whose needs could not be met in the standard fast-food medical model. If a doctor taking Medicare or conventional insurance has to average 7 minutes per office visit just to pay the overhead, there's no way he can do justice to his patient's medical needs.

2) Concierge medicine is not just for the wealthy. Those services are affordable to patients of modest means, if they are willing to budget for them and place a high priority on good medical care. It's no different from the fact that some parents who really value their kids' education will make it a priority to budget carefully and send their kids to a good private school rather than subject them to the harms of a government-run public school.

3) Both parties win because concierge medicine represents a shift towards free-market principles. Patients receive the care they need at a fair price. Physicians are able to practice according to their medical conscience, while being appropriately compensated. This is just an example of the broader virtue of free markets, where buyers and sellers exchange money for services on a purely voluntary basis. In a free market, the exchange occurs only if both parties deem it to be in their benefit. The concierge physician succeeds only by offering a genuine value to his patient. Hence, they are willing and eager to do so, as the many happy patients in the article can attest to.

If you want to protect yourself from the upcoming fiasco of "universal" Obama-Care, follow Dr. Knope's advice:
Maintain your private medical care if at all possible. If you are relatively healthy, look into a high-deductible health insurance plan linked to a Health Savings Account (HSA). Start putting money away in that HSA for a rainy day. Find a "concierge physician" or doctor with whom you can establish a direct financial relationship; someone who will act as your medical advocate in a system that is broken and will only get worse. You get what you pay for and medicine today is no different.
After all, it's your life at stake.