Just half a year into his congressional tenure, Chip Roy is taking the oft-abandoned helm of the Republican Party’s lead on healthcare reform. For nearly a decade, Republicans have promised to repeal and replace the Affordable Healthcare Act, and for nearly a decade, Republicans have proven themselves to be incompetent at best and liars at worst. But if Roy’s opinion piece at The Federalist on the matter is any indication of what’s to come from his office, Republicans may actually prove capable of tackling the underlying problems plaguing our broken healthcare market at last.
Most vitally, Roy understands that this market is no longer a market. Our employer-based insurance model has severed consumers from healthcare providers, rendering the prescription drug market, hospital pricing, and physicians functionally unresponsive to patient demand. Roy aims to tackle the extreme inelasticity of the healthcare pricing by giving consumers more power to pay out of pocket, untaxed, for better choices in healthcare. The Texas congressman identifies what may become the silver bullet for Obamacare: direct primary care models.
Colloquially referred to as “concierge care,” direct primary care models began as designer healthcare plans: subscription-based programs where, for thousands of dollars annually, your doctor is on retainer. Direct primary care models boast shorter wait times, fewer patients per practice, and increased focus on preventative care, in some cases even including risk reducers such as dietetics. But while the cost has historically been prohibitive, start-ups such as One Medical and Forward are rapidly reducing the costs and accessibility of direct primary care plans. Some, like One Medical, require out of pocket fees, just a few hundred dollars, and accept insurance to cover some of the costs, all of which are reduced by a mixture of physicians, nurses, and PAs as well as apps that allow patients to receive virtual care. Others dispense of insurance entirely. Forward doesn’t accept insurance, period, instead charging a flat $150 fee every month with no other costs, period.
As mapped out but not detailed, Roy’s plan could pivotally create a lane for this market to grow. If insurance standards were reformed to allow for better high-deductible, low-premium catastrophic coverage, we could theoretically dismantle the employer-based model completely, with Americans purchasing cheap concierge care and catastrophic coverage, paying out of pocket for specialists and pulling down list prices of such care by rendering specialist services more responsive to consumer demand.
The details remain to be seen of Roy’s Healthcare Freedom plan. If growing up in the post-Obamacare era has taught me anything, it’s to never trust one word from a Swamp Monster’s promise to repeal and replace the ACA. But Roy may be a different kind of politician. As the healthcare market crumbles and “Medicare for all” proves ascendant, I’m holding out hope that Roy’s plan is as pointed as promised.
