An Alabama law went into effect Sept 1st that will help facilitate healthcare freedom in the state, and set the stage for the people there to nullify in practice federal control over the healthcare industry.

Sen. Arthur Orr (R-Decatur) sponsored Senate Bill 94 (SB94). The new law specifies that direct primary care agreements (sometimes called medical retainer agreements) do not constitute insurance, thereby freeing doctors and patients from the onerous requirements and regulations under the state insurance code. The bill also provides that a physician or dentist offering, marketing, selling, or entering into physician or dentist agreements will not be required to obtain a license or certificate of authority from any state entity. SB94 sets certain requirement such agreements would have to meet.

The Senate passed SB94 by a 27-0 margin. The House followed up passing the measure 102-0. With Gov. Kay Ivey’s signature, the new law became effective Sept. 1.

According to Michigan Capitol Confidential, by removing a third party payer from the equation, medical retainer agreements help both physicians and patients minimize costs. Jack Spencer writes:

Under medical retainer agreements, patients make monthly payments to a physician who in return agrees to provide a menu of routine services at no extra charge. Because no insurance company stands between patient and doctor, the hassles and expense of bureaucratic red tape are eliminated, which have resulted in dramatic cost reductions. Routine primary care services (and the bureaucracy required to reimburse them) are estimated to consume 40 cents out of every dollar spent on insurance policies, so lower premiums for a given amount of coverage are another potential benefit.

This represents the kind of cost control Obamacare promised, but failed to deliver. Last fall, Tom Woods interviewed a Kansas doctor who utilizes the direct primary care model. Dr. Josh Umbehr’s practice demonstrates the cost savings possible when doctors are unfettered from the bureaucratic health insurance system.

Under Obamacare, regulations define such programs as a primary care service and not a health insurance plan, and current IRS policy treats these monthly fee arrangements just like another health plan.

A FIRST STEP

At this point, it doesn’t look like Republicans will repeal or even reform Obamacare, and the changes to the ACA proposed by the GOP would have arguably made things worse. Regardless,state actions can help completely bring down the Affordable Care Act , or any national healthcare plan the Congress comes up with in the future.

Oftentimes, supporters of Obamacare criticize opponents for not having any alternative. Direct primary care offers one.

These direct patient/doctor agreements allow a system uncontrolled by government regulations to develop. It makes doctors responsive to patients, not insurance company bureaucrats or government rule-makers. Allowing patients to contract directly with doctors via medical retainer agreements opens the market. Under such agreements, market forces will set price for services based on both demand instead of relying on central planners with a political agenda. The end-result will be better care delivered at a lower cost.

By incentivizing creative healthcare solutions, the market will naturally provide better options, such as the Surgery Center of Oklahoma, This facility operates completely outside of the insurance system, providing a low-cost alternative for many surgical procedures.
A more open healthcare marketplace within a state will help spur de facto nullification the federal program by providing an affordable alternative. As patients flock to these arrangements and others spurred by ingenuity and market forces, the old system will begin to crumble.

This new Alabama law takes a first step toward healthcare freedom in the Yellowhammer State, and would create a stepping stone to further action to nullify the onerous Affordable Care act. Once in place, Alabamans could take further steps to fully extricate themselves from Obamacare for good.



http://blog.tenthamendmentcenter.com/author/michael-maharrey/

Looks intriguing but what can go wrong?

democrats...

not much, its nothing new

operating much like the already existing 'discount plans' people can enter where certain physicians will offer cheaper services to members ,,,

they also have disclaimers that they are 'not insurance'

I like Mexicare better, it's free.

I'm not seeing how it in any way alleviates the costs of the ACA. All this does, is relabel a certain kind of health care arrangement, so that it isn't regulated by the ACA. In a way, doesn't it raise people's costs, since such arrangements wouldn't qualify as health plans, for the sake of avoiding the ACA tax penalty?

i'm guessing by eliminating the "middle man" (insurance) that prices should be lowered and less confusing about what is or isn't covered...

I get how it's got the potential to lower some costs, but since the article says that they specifically said that such agreements do NOT count as insurance, doesn't that mean that people using them will still have to buy insurance as well, to avoid the penalty? That's the part I'm missing.

Looks to me to work like medical savings accounts do. It will cover some basic services, but it will still require you to carry "catastrophic" medical insurance. To me you no longer have insurance companies that set prices for procedures and so doctors or clinics could actually charge you more for services. I recently brought my daughter to urgent care to get her ear flushed out, we knew what we needed, she has had problems with her ears so we went in to get it done. The hospital where the urgent care was sent me a bill for $340, but it was knocked down to $170. I payed it and 2 weeks later the hospital sent me a bill for clinic visit for $192 and services for $131. So the total cost for the half hour we were there was $663, but of that I had to pay $493. The point is they charged $170 just to pull our names up in a file and send out a bill. The amount of paper work involved with out even dealing with an insurance company is unrealistic, and if you did sign up for such a plan how much would you really be covered for? And how much bait and switch would go on? The doctors will probably end up.pushing more drugs and procedures on patients that they get kick backs on in order to push up there profits. Basically a HMO runs a similar program where they control the money and keep as much in their network as possible.So long story short this doesn't appear to be a great new idea that will give more people better care or save them money. Unless we can control drug and medical services cost health care will continue to spin out of control and it just comes down to what people are willing to put up with.

In any case, too much of the talk in the article is standard wishful thinking. The repeated idea that "natural market forces" will by themselves, solve the problems of expensive medical care, is belied by the fact that they only came to be in the condition they are now, BECAUSE of "natural market forces." Government intervention is extremely recent, and is NOT the primary cause of high costs.

The market itself is.

The nature of medical need and care is such, that patients CAN'T "shop around" for the best prices or services. Most of the time, the needs are so imperative, that whoever is closest has to perform whatever tasks are required. "Market forces" thereby dictate that hospitals be established and supplied with enough resources to deal with the majority of needs which might arise for a given area. The very high cost of such a facility can't be avoided, because nothing smaller could deal with the medical needs of the community are likely to generate. Even a small facility will have expenses much greater than non-medical businesses of the same size.

High cost, means high pricing. And ALL medical resources, including humans, are steady-state costs. They cost just as much to keep ready, as they do at the moment they are needed. So the immediate cost of the procedures and materials involved, can't be priced JUST to cover the immediate procedure, they must charge much more, in order to pay for the preparation and "idle" time.

Insurance was and is a "Natural Market Forces" solution to the needs being presented to the medical scenario. It was not invented by the government. And once the Insurance Model is in place and working to reduce medical costs of individuals to predictable levels, other "natural market forces" follow on.

That is, the insurance companies, for normal every day market forces reasons, will try to make sure that they make a profit. To do that, requires several things, including refusing coverage to people who are most
likely to need it; and refusing to cover any expenses which aren't certain to be effective. That eliminates coverage for any experimental procedures, as well as demanding that treatments be pre-established, in order to make costs predictable enough for insurance to be appropriately priced. Again, "natural market forces," directly causing high costs, AND more processes and procedures being required for every patient, in order to make sure that insurance will pay.

So enough with "natural market forces" being touted as the fairy tale ending to high medical costs. They ARE the reason for those high costs.

that last statement is just ignorant...the reasons for high costs is insurance companies and greedy doctors...

The reason for the high costs is the attitude that the insurance company will pay for it. People go to the doctor and they don't care how much. it cost because insurance is paying for it. Doctors charge what they want and the insurance companies pay them. Drug companies and medical manufacturer's change whatever they want because its just the insurance companies that are going to end up paying for it, but everyone forgets its the people paying into the insurance companies that are really the ones paying for all these increased costs. So when your insurance policy now has a $10,000 deductible you start to realize how much, and how fast that adds up for simple trips to the doctors and the medicines you are on. Many insurance companies have stopped doing ACA do to the fact they were losing money on it. So its about gaining control of why people go to the doctor,and why the doctors, clinics, and drug companies charge so much.

Hmm. That's EXACTLY what Hillary Clinton said. I take it you voted for her for President then?

Big corporations are running the show with their CEO'S and lawyers instituting laws and loopholes. Super Pac's, lobying and so on. (Legalized bribery). Just ask the politicians in Washington. Just a little more on the complexity of the subject. What rigged system?

That certainly does play a part, but insurance had to be set as a normal and basic part of the entire process BEFORE that mode of thinking could spring up.

You also point out one of the newer "solutions" which people get annoyed by: high deductibles. What high deductibles are specifically designed for, is to sell more money-making insurance. Natural Market Forces in action yet again. In order to pay LESS for your "insurance," the companies do the only thing that capitalism allows them TO do: reduce how much they actually pay out. That can't be done and sold to the customers by directly saying "you can save on insurance costs by not being able to use what insurance you pay for," so instead, they hide that behind making everyone pay for the most common lesser medical costs entirely.

Another "solution" that has muddled things up, to deal with the problem of providers deciding to "change whatever they want because its just the insurance companies that are going to end up paying for it," is ANOTHER 'Natural Market Forces" act: the setting up of a stabilizing authority to set price and practice limits. The AMA does that in the US. It didn't take on the role of price and medical procedure controller because the government wanted it to, it did so because the INSURANCE COMPANIES wanted it to. You will find, after all, that providers really CAN'T just charge whatever they want, because the AMA tells the insurance companies, who then tell the providers, how much they WILL pay for each procedure, and even what the procedure includes. Very UN-natural-market-forcish, yet still caused directly by market force concepts.

Over all, the single most important thing to understand about Capitalism and "market forces," is that they are not, and have never EVER reduced prices to consumers, because they feel emotionally rewarded for doing so. Lowering selling prices is NEVER a primary function of "market forces," it is just a common SIDE EFFECT. And what capitalists have always done, when left to their own devices, is to find ways OTHER than lowering prices, to get people to buy their wares.

And that's finally why Free Market Forces can NEVER be what is allowed to guide things like Medical services. Because the PRODUCT of medical services, is not at it's best, after market forces are done with it. The lowest cost, most efficiently handled medical patient, is one who has been recognized to have needs in excess of value early on, and been discarded.

I forgot to mention the senators that are sitting in the money seat.

Reason for high cost!
Definitely right. It's the same with anything done through insurance. I'm in the building profession and insurance work usually doubles or at least half again the price. This goes for vehicle damage repairs and everything else!

I never heard her say anything close to that smart...

I got certified for auto damage appraisal.
There is a term in the business called LKQ = Like, Kind, Quality

When an insurance claim is assessed it is to restore the vehicle to LKQ. Costs are based on Manufacturer's cost assessments which is available in database. Part of the assessors job is to assess which damage is related to the incident being insured. There is a depreciation scale that is used.

No matter what the assessor submits it is up to the insurance company if they cover it. I have seen insurance companies kick back an assessment because it was too high. It delays payment to the insured and effects your reputation as an assessor.

I worked a very short period of my career in the public sector.
Most of my career was in fleet repair. In fleet repair I was an inspector. Some companies used LKQ and some did not. Most companies only wanted what was needed to safely operate the unit fixed. Others concerned themselves with keeping the units at near original conditions. Cost wise, both had advantages. The pristine fleets required less unit replacements but instead had heavy preventive maintenance, the keep it running companies had lower maintenance costs but had to replace units quicker.

As a mechanic I find truck repair similar to health care. I'm not sure if this information adds any thing to the discussion but I really enjoyed listening to my typing.

Yes, you need a touch type keyboard, I could hear the tapping over here
I think you can generalise the insurance industry or people who claim.