Local doctor changes healthcare: Charges monthly rate instead of Insurance, Medicare or Medicaid

Wow..

I did not know that this was allowed in the US. I myself do not live in the US but this looks like it could be beneficial to many people across the country..

Two of his patients Mark and Lisa Pendlebery already have health insurance. However they pay the extra for Lambert's accessibility and care. And apparently it seems it saves them money...

Dr. Robert Lamberts in Martinez is changing the world of healthcare, at least in his office. He doesn't accept insurance, Medicare or Medicaid. Instead, He's charging patients a flat monthly rate to be their primary care doctor as much as they need.

"We don't control the system," said Lamberts. "It's the insurance companies and the government that control our healthcare system up to now."

After 18 years in the healthcare world that Doctor Robert Lamberts calls flawed, he decided to make a major change.

Lamberts' practice is focused on keeping patients healthy and out of the doctor's office.

He talks to patients often through instant messaging, texts, emails- whatever it takes to treat small problems before they become serious.

He says the healthier his patients are, the more patients he can care for. In his office, that means more money. Patients are charged a flat monthly rate of thirty to sixty dollars a person.

"What I'm offering for that money is me. It's accessibility. It's being able to contact me before the problem gets big."

www.nbc26.tv...

So peeps of ATS who live in the US. What say you. Is this a good idea.. Or is it a bad idea...

Peace
Fluff

Wow!
He sounds like an amazing doctor, one that actually cares about his patients. I think this is a great idea.
Unfortunately I could see him getting hassled by the insurance companies and maybe even the feds. Which is terrible, because he really is doing a great thing. I would go to him, if I lived near there.

If you have the extra income to put a doc on retainer then go for it. All he is doing is offering to be more responsive than docs usually are. It is not like if something serious happened the doc would foot the hospital bill that was incurred. He isn't really changing anything since he is just the doctor. Sure he can see patients and diagnose them but they still have to be on an insurance plan to actually get anything done or get prescriptions. Basically they are just paying for the convenience of having a doctor at their disposal for over the phone diagnosis of simple ailments.

I have seen a few docs that don't take insurance and take a mostly holistic approach. They are good, but having to pay them AND have insurance is just paying double for what you already have and the extra really does you no good in the long run if you truly have a need for medication or hospitalization.

From his website:

WHAT ABOUT PEOPLE WHO HAVE INSURANCE?

My fee covers only my services, not the cost of visits to specialists or many of the tests I may order. This means that insurance may still be needed for much of the care I may order. All patients, regardless of insurance status, pay the same a monthly “subscription” for my care and receive the same services. No patient is turned away because of insurance, and no one is turned down for pre-existing conditions.

WHAT ABOUT LABS, PRESCRIPTIONS, OR X-RAYS?

For patients with insurance, these tests will be billed to insurance by the lab, pharmacy, or radiology provider in the usual manner. For those without insurance Labs run in my office are included in the monthly fee, and I will work to find ways to significantly reduce the cost of tests, labs and prescriptions wherever possible.

WHAT ABOUT ER VISITS, HOSPITALIZATIONS, OR VISITS TO SPECIALISTS?

Any other contact with the rest of the health care system will be covered as usual. I will refer patients to specialists or for procedures as appropriate, and those providers submit this to the insurance provider.

So really anyone seeing him is just paying double until ALL of the healthcare world follows the same practice.

Seems like a nice enough guy but also has found a good money making scheme in my opinion. He no longer has to pay insurance companies yet reaps the benefits of those that do by charging more than the typical co-pay with insurance would be per month.

How often do any of us actually go to see the doctor? I know I don't go once a month....wonder if he will do it just month to month or if it is like a contract you have to sign and honor for a year before you can break it.

It seems like a fair deal. I pay $152 a month, equal to one quarter of my premiums as my company picks up the other three quarters, for health insurance that I basically never use. Then if and when I visit a doctor, I pay another $30 copay. This doctor's deal is a real bargain compared to what I pay to insurance companies who offer me little to nothing for nearly $7300 per year. It must be the high cost of profit and outrageous CEO pay.

reply to post by chiefsmom


Amazing doctors are few and far between. I had surgery on my hands last thursday and my surgeon was awesome..! He was so helpful and he actually seemed genuinely concerned for my welfare..! So many doctors these days just see it as a job. You are a number to them and not a person.. It is very sad really..

When I saw this article I thought it was a fab idea - but then not actually living in the states I thought you guys would be a better judge....

reply to post by Vasa Croe


Thanks for your reply Vasa

Well the thought had crossed my mind that he could just be scamming people. But I do not know if he is or not. Seemingly he has a national following of other doctors who are monitoring his regime and are considering the same move if it is successful..

Aah I did not completely understand that you still have to pay for your health insurance as well as his flat monthly fee...

Well I shall keep my eyes on this and see if it comes to any fruition of sorts..

reply to post by fluff007


I've been to a few doctors, that could not get you out of the office fast enough and it makes me mad as heck.

I just thought of something else about this doctor doing it this way.
I lost our last doctor, because I hadn't been to the doc in 3 years, so they dropped me!!!!
So, I would think, that if you were paying, basically keeping him on retainer, you wouldn't be dropped.

It would also be nice, for someone with small children. To be able to call the doctor, in the middle of the night when something happens, like an earache or such, would be comforting.

Originally posted by fluff007
reply to post by Vasa Croe

 

Thanks for your reply Vasa

Well the thought had crossed my mind that he could just be scamming people. But I do not know if he is or not. Seemingly he has a national following of other doctors who are monitoring his regime and are considering the same move if it is successful..

Aah I did not completely understand that you still have to pay for your health insurance as well as his flat monthly fee...

Well I shall keep my eyes on this and see if it comes to any fruition of sorts..

I mean technically you don't have to pay for the health insurance as well if you are solely seeing this doc, but if something comes up that requires hospitalization or prescriptions or tests then without it the patient is paying out of pocket which is insanely high. Another issue is if the patient does not have coverage yet the doc that is seeing them diagnoses them with something that requires a hospital visit or whatever then they most likely will not be able to get insurance coverage because the issue is now a diagnosed and previously known ailment that the insurance company will not touch.

Unless the entire system changes this particular type of healthcare will be a very small minority or fail all together.

Now if this doc got together with thousands of other docs and opened up a privatized hospital and offered this type of service with prescription and in-patient type care that would be a different story. I would forsee it as a sort of "doc-in-a-box" type of scenario but "hospital-in-a-box". There are plenty of clinics around that are inexpensive and diagnose smaller issues and can treat and prescribe whatever but if someone were to open a hospital or few under the same premise, that would be a game changer.

While this doctor's monthly rate system may seem like a good idea for minor ills, I'd rather have insurance to cover the outrageous costs of other things like diagnostics, medical specialists, ER visits, hospitalization, surgery, etc.

Originally posted by chiefsmom
reply to post by fluff007

 

I've been to a few doctors, that could not get you out of the office fast enough and it makes me mad as heck.

I just thought of something else about this doctor doing it this way.
I lost our last doctor, because I hadn't been to the doc in 3 years, so they dropped me!!!!
So, I would think, that if you were paying, basically keeping him on retainer, you wouldn't be dropped.

It would also be nice, for someone with small children. To be able to call the doctor, in the middle of the night when something happens, like an earache or such, would be comforting.

Most doc offices, especially pediatrics, have a nurses line for after hours calls. I would assume that is what you would get with this doc as well. While he may say he answers whenever, the guy is a doctor, is most likely busy and does have to sleep. Also, what is his limit for patients? When does he cut off the number of calls he can answer and treat over the phone? He is opening a big can of worms with these statements because he could take on some patients that are hypochondriacs and call him incessantly and tie up all his time taking advantage of the ability to do so. Eventually he will be so saturated that he can't offer this type of service to his patients, at which point what can he do? He can hire others but then you are not getting his care personally so how much do you charge? Do you charge less if a nurse contacts your patients or continue to charge the same rate? There are way too many variables for him to be able to sustain this type of practice for an extended period of time without having a large group of docs and nurses on a temporary staff rotation type schedule for after hours calls and whatnot.

Originally posted by LeatherNLace
While this doctor's monthly rate system may seem like a good idea for minor ills, I'd rather have insurance to cover the outrageous costs of other things like diagnostics, medical specialists, ER visits, hospitalization, surgery, etc.

Same here.....without insurance the birth of my last daughter would have cost me over $500K with NICU and wife's hospital bed rest.

Now if you are perfectly healthy then fine, but you can always have an accident and without insurance you come out of pocket on everything and even if you end up getting insurance at a later date after the accident they will not cover ANYTHING that may be deemed a pre-existing condition or related in any way to that accident when you did not have coverage.

There is a local Dr. In my area who does this as well. Although, I think it would be cheaper to pay for insurance with his prices.

I think this could be both good and bad. It helps people out who do not have or cannot get insurance. But the fact that the number of Drs. Who actually do this are so low, it will over run that office/practice and it will take weeks to get in for an appointment.

The Dr. In my area that does it, charges a “Start up fee” and that includes a full 1+ Hour work up, from family history to what you ate for breakfast, and then you pay a fee every month to “Be a patient” as well as when you go in.

ETA: He also only sees a handful of patients a year. There is a "waiting list" to be come a patient. I want to say hes patient load is only around 2,000.

Only way I'd pay an extra 30-60 bucks a month is if he made house calls.

Otherwise my current doctor is just fine.

This is called concierge medicine it is not new but it is not common. It is what the TV series Royal Pains is based on.

en.wikipedia.org...

I have a daughter who was born with several heart defects. (I'm lucky to live near a fantastic children's hospital.) After the first ten months of her life were spent in the CICU (Cardiac Intensive Care Unit) and four open heart surgeries I was offered a concierge pediatric cardiologists' services through the hospital and the recommendations of the surgeons. She had "permissions" for all of our local hospitals and the children's hospital (in case my daughter ended up in an emergency room). She did home visits, mostly because of the amount of equipment required to monitor children who have undergone such extensive surgeries/structural changes to their hearts/weak immune systems that result from such things. I was happy to pay her. It was comforting. After 6 months when I had never called her to my home and my daughter did not have any cardiac events, I released her.

Concierge medicine has its place and its time. It can be very appropriate, even while paying for health insurance.

reply to post by fluff007

before the national health system came into effect in 1948 , this is just how the doctors operated in the uk .

This doctor is essentially charging for warranty services, like a car repair shop...you pay the 30-60 bucks a month and only get repairs twice a year...

Doctors used to take chickens for payment...

reply to post by fluff007


I can only speak on what I want from the field of medicine. If I'm not feeling well, I want a walk-in clinic, not an appointment for three weeks later. All this garbage about offering HEALTH care is just to keep doctors in their million dollar homes. If people don't know how to eat right and exercise to stay healthy, then it's their parents fault for not teaching them. We don't need to pay a doctor every month to 'keep us healthy'.

According to this I want to open a pizza parlor and charge everyone a monthly fee. Point being, why do doctors think they should be guaranteed an income instead of having to survive under the practice of supply and demand like the rest of us?

I don't want health insurance, or even whatever is this doctor is offering. I want MEDICAL insurance.

Be on the look out in the coming months for him to be shut down because he is undermining socialized health care.

This guy is real dangerous.

End sarcasm.

I think it is a good idea. It is sort of like socialized health care. Teaching people is what doctors should do, most of our diseases and health problems stem from metabolic differences. I'm not talking about eating healthy, I'm talking about eating what is right for your body and mind. I think socialized health care is the best solution. I see problems with other things in socialism but not in healthcare. Look at what an employer pays for your insurance and for workmans comp and other insurances he has to carry that include coverage for healthcare. Look at the liability of your homeowners insurance, it covers doctor and hospital bills. Add that all up.....That is probably more than the government would charge for health coverage. No more doctors having malpractice insurance costs, no more lawyers costs added to our doctor overall costs. Seems that the only losers are insurance salesmen and lawyers....and Pharma companies big time. Never happen