Power to the Patient

by James Wantuck, MD

The current US health system is not a patient driven model. In fact, the power lies in the hands of employers, health insurance providers, device manufacturers, hospitals — basically every entity except for the patient, the one who receives and ultimately pays considerably for the care. Physicians provide a service to the patient, but the patient is not the customer. The customer (who is paying for the service) is the insurance company and thus the system is built to serve them. Why is this problematic? Because it causes patients logistical hassles, a lack of price transparency, and no incentive for doctors to deliver patient-centered care. Essentially, this traditional health system keeps patients in the dark, and keeps the power in the hands of faceless institutions. Let’s give the power to the patients!

The lack of transparency and value in health care doesn’t have to be part of the system. For example, did you know that it costs only $13,660 for an American to have hip replacement surgery in Belgium? In 2013, The New York Times chronicled one man’s experience of seeking hip replacement surgery in the US only to find out he’d been priced out of the costly health system at play in our country. After some research, he discovered he was able to cover his round-trip plane ticket from the US to Belgium, the cost of the hip implant, hospital fees (including a five day stay in a private hospital), crutches, surgeon’s fees, and a week of rehab all for $13,660.

Guess how much the same procedure costs in the US?

Around $100,000.

While it only costs around $350 to make an artificial hip in the US, the price is enormously inflated because joint replacements in this country are primarily made by 5 companies that make small changes to old patents and use this as a reason to increase prices dramatically, year after year. In addition, these companies create strong ties with doctors strengthening allegiances and require hospitals to sign NDAs so they don’t know what their competitors are paying, further diminishing any possibility for bargaining power, keeping prices high and consumers burdened with rising costs. In addition to the inflated prices of medical devices, the traditional American healthcare system is riddled with itemized fees for every different component of a healthcare procedure. So, instead of Americans being billed one fee for hip replacement surgery, they’re billed for multiple separate fees that cover everything from X-rays to operating rooms to doctors, and beyond. This process applies to every single health care experience in the system. By obfuscating prices and confusing patients they avoid providing value. Indeed, doctors themselves are largely unaware of the cost of medications, devices, and even their own services!

The approach to digital health used by many has been to take the broken system and put it on a website. These companies have been too afraid to break the current reimbursement model. They work with traditional insurance, employers, and health systems and by doing so they’re not revolutionizing the old system, but exacerbating what hasn’t been working for years. At PlushCare, we’re creating a novel experience that’s patient driven: we provide value, transparency, and access. Our motto is “Delivering health and happiness.” Anyone can come to PlushCare when they need our help. We provide connected care, starting with virtual doctor visits — and we will help you navigate the health system whatever your needs are. Our price is visible and our patients don’t receive follow-up bills in the mail after their appointments. We’re actually revolutionizing health care — we know first hand how broken it is and we know our patients deserve better.

PlushCare provides virtual doctor’s visits from the comfort of your home, office, or wherever you’re located. For $49 our world-class doctors will diagnose, treat, and prescribe you medication. For more information or to book an appointment, visit plushcare.com.