I just finished a family med rotation with a doctor who is doing just that - trying to remove the middle man from the equation. Just briefly, his system is set up so that you pay a fee (around $80) each month directly to the clinic - and are entitled to as many visits as you desire for that period. Visits to the clinic include all vaccinations, well person visits, most routine blood work (lipids, glucose, liver enzymes, cbc, etc), xrays, minor procedures like suturing, ekgs, and everything else that can be done in house. That price also gets you a decent med formulary (with things like insulin costing just a few dollars more). Like I mentioned - single payer is around $80 and a family (with no size limit) is less than $150. Now, obviously, hospitalizations aren't covered - so he recommends a high deductible insurance for that - which if you shop around aren't too pricey. But really, most visits to a doctor can be handled in a well equipped clinic. It's amazing how hard he fought for this - all the while battling both the insurance lobby and the state government as well. His is a unique system.

Here's a link to a story on his system that ran in Medical Economics - http://mediwire.skyscape.com/main/Default.aspx?P=Content&ArticleID=390167

While I was there a reporter from the WSJ spent a few days with Dr. Wood for a story on his system for that paper.

Now, I'm not saying this is the end-all system - but it's exciting to see doctors and not politicians or industry trying to make a difference.

He told me something one day that will probably always stick in my mind - health insurance is not health care.

Dan