I realized the system was broken,
so much to the point that
I was part of the problem
of contributing to that broken system.
- Dr. Timothy Wong doesn't take any insurance in his practice -
and charges most of his patients $35 for a consultation.
We would always have to fight the insurance companies
getting something a patient required.
We're talking about having to do extra work
just to get a diabetic the insulin they need;
having to get a patient a life-sustaining medication,
and having to give her samples,
just so that she doesn't end up in the hospital again.
Health care is the only industry, I think,
that we really turn customers away.
We could do better as providers.
We can buck the system and change it.
- After working at a hospital for four years,
Dr. Wong decided to quit his job
and open his own primary care clinic in Pittsburgh.
He's one of a growing number of doctors who are looking
for ways to cut the insurance companies out.
Not taking insurance is a defiance
because it's against the traditional way we do things.
- Health insurance is a trillion-dollar industry in the U.S.
And profits are on the rise,
but medical costs keep going up.
And by taking this insurance, we also get paid by the insurance.
So, they become our masters in a lot of ways.
- Dr. Wong is able to treat the vast majority
of routine ailments as a primary care doctor,
but can't provide emergency care or specialist expertise.
That means all of Dr. Wong’s patients pay a flat fee of $35
for primary care and $10 for each additional ailment.
There are no hidden fees, copays or bills that show up in the mail later.
$35 might be more than you paid for your last doctors visit,
but consider all the other potential fees associated with insurance.
Copays are the set amount you pay for doctors visits and prescriptions,
plus premiums every month to insurance companies.
Deductibles are how much you pay out-of-pocket each year
before your coverage kicks in.
Coinsurances are a percentage you pay
even after your deductible has been met.
Health care pricing is just confusing.
It’s like not knowing how much a hamburger costs
until after you’ve already eaten it.
And Dr. Wong believes you don't need insurance to cover basic care, like
stitches, flu shots or a sprained ankle.
Part of our philosophy is to keep things simple,
but also to keep our costs low,
so that we can pass that off to patients.
- Dr. Wong is the only employee.
There’s no receptionist, nurse or assistant.
Patients sign in on an iPad and wait until he calls them in.
I was at work,
put my finger in the mixer,
and it's smashed.
- Brent drove over an hour to get to the iHealth Clinic.
I've dealt with this kind of injury before.
I've paid thousands of dollars,
even with my insurance.
Last time was actually $750 out-of-pocket
for two stitches.
- The most Dr. Wong says he's charged a patient?
$55.
That doesn’t include things like testing or medication.
But he works with patients to find affordable options.
I think a true primary care provider is a patient's advocate.
- Dr. Wong says he used to do a lot of extra work
just for insurance companies.
It was almost to the point where I would tell the patients,
you know what? I'll do this after you leave.
There's really nothing I'm doing face-to-face with you
that's providing you a benefit.
I'm just, you know, working on the computer
or filling out forms that the insurance wanted.
- Both the endless paperwork and emotional stress Dr. Wong experienced
while working with insurance companies led him to feel burnt out.
More than half of U.S. doctors have reported symptoms of burnout.
Physician burnout, or burnout in the health care industry,
is called by other people moral injury.
And moral injury occurs when we are asked every day,
and constantly, to do something that is against our morals.
- While Dr. Wong doesn’t want to work with insurance companies,
he acknowledges that his clinic is not a replacement for insurance coverage.
Catastrophic care is very important.
You don't want to go into personal debt,
you know, for a lifetime because of an accident
when an insurance could have covered that.
- The American Medical Association hasn’t taken a stance
on doctors cutting out insurance companies,
but says it supports their right to choose.
But I think a lot of providers don't realize that this model exists,
and it could fit them very well.
They might not get paid as much, but their job satisfaction gets better.
- There’s not enough data yet on the long-term impact of models like this.
But Dr. Wong believes he’s already making a difference.
We can decrease the cost of care. We can increase efficiency.
We can increase access of primary care and urgent care services
to those who need it.
And I think you can improve people's lives that way.
- At his last job,
Dr. Wong says he was lucky to get a handshake from a patient.
I've never had such gratitude from patients.
Just this week, I saw someone drive by
and give me the thumbs-up
as I was closing the door
because I think she kind of knew about what we were trying to do here.
If I have a 1% chance
of changing the health care system for the better,
it is a worthwhile endeavor.
Hey everyone, it's Adrienne.
Has health insurance, or the lack of it, affected you or someone you care about?
We want to hear from you in the comments below.
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