“Netflix for Healthcare”: Local Doctor says Direct Primary Care Cuts Out Insurance Costs

Dr. Timothy Murray runs Solstice Health in Oconomowoc. He says the current primary care system is too expensive because of insurance companies and administrative salaries.

“I shouldn’t be able to charge $400 for an MRI when the hospital charges $3,000. I mean you can just do the math right there and see the markup.”

Direct primary care cuts a lot of those costs, and Murray says 40 percent of his overhead is removed. For a monthly fee, you get unlimited visits to doctors and non-emergency services.

“There’s no thought process anymore of should I go, or should I not go. My kids got a cold, or maybe he’s got an ear infection. I’m really not sure, but my deductible is $2,000, and I know I’m going to have to foot that whole bill.”

But there is no emergency room at Solstice, so Murray says he also reccomends catostrophic health insurance both for safety, and to meet Affordable Care Act requirements. Murray says to think of it like car insurance.

“Your car insurance doesn’t pay for your wiper blades. It doesn’t pay for your tire rotations and all these other day to day things that we do for our vehicles. That is the essence of primary care. When you have an accident, or you have something catastrophic, that’s when the insurance kicks in.”

A group of Republican lawmakers, including state Rep. Joe Sanfelippo, R-New Berlin, are putting laws on the books to define and regulate direct care, to help get it off the ground.”

“As time goes on, you’re going to see this focus going away from our legacy system, where it relies on insurance companies as the key, to this primary care model, where the patient is the king.”

The bill on primary care has already passed the state Assembly, and is up for a vote in the Senate.