Sunday, May 04, 2008

The “third tier” in US health care?

It’s a sickening situation. Physicians’ incomes are under attack: think lower reimbursements, higher costs for malpractice premiums and the like, greater business costs, claims processing hassles, and deadbeats.

What’s a poor doctor to do? One possible cure is the concept of Concierge Care.

Concierge Care (or Boutique Medicine, or Platinum Practices, one name hasn’t stuck) could offer a patient such privileges as 24-hour phone or pager access to the doctor, house calls, and guarantee of an appointment with your chosen doctor the same day you call.

The cost: a fixed annual fee that could range beyond $20,000 a year, depending on the services provided, and the patient’s age and health.

I’m not quite old enough to remember the days when doctors offered all the above and a lot more to everyone, for a lot less.

So there it is: to the other tiered services available in the US (UPS for the rich, the post office for everyone else; private schools for the rich, public schools for everyone else) we can now add a three-tiered “health” care system: no coverage at all for 45 million people, inadequate medical services for most of the rest of us, and Concierge Care for the lucky, wealthy few.

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