Vince Coakley Radio Show 3-10-2017 Hour 2

vince coakley


Vince talks with Dr. Bob Nelson about the health care situation.

Source: Vince Coakley Radio Show 3-10-2017 Hour 2

Debunking Media-Supported Myths about DPC: A Conversation with Dr. Brian Forrest — Hint Health

Dr. Brian Forrest. PHOTOGRAPHS BY DEREK ANDERSON After growing frustrated with the patient volume and time requirements of managed care, Dr. Brian Forrest started his own practice with a unique model of care. Its flat-rate fee and longer office visits have proven popular with patients.

Dr. Brian Forrest

As a seasoned advocate and DPC practitioner, Dr. Brian Forrest knows all to well the problems that misinformation can create for a movement built almost entirely on word of mouth. In the second installment of our ongoing series, Dr. Forrest provides a healthy dose of reality and debunks the nine most dangerous myths about DPC.

Source: Debunking Media-Supported Myths about DPC: A Conversation with Dr. Brian Forrest — Hint Health

Irrational Healthcare Payment System Drives Costs And Why Payers Go Along With It | Robert Nelson, MD | LinkedIn

Our third-party payer system, by the nature of how coding & billing is contractually mandated, promotes increased health spending on aggregate – and the economic design of the system includes a perverse incentive to keep the spending going. 

real-health-care-expenditures-and-third-party-largerThis occurs in large part due to price insensitivity on the consumer-patient side due to the low marginal cost of entry compared to the inflated CPT billed charges which serve as a pivot point for network discounts. i.e. ~ once a co-pay is paid, patients don’t have any incentive to know or care what is done or how much it costs. 


These perverse motivations are what keeps premiums going up and up… Without utilization (claims), there is no other way to grow the pie because payers are not free to make a higher profit margin beyond the mandated cap, even if they do things to lower aggregate utilization which might lower premiums for everyone.  In other words, payers are not rewarded for efficiency, they reap financial reward to the extent that utilization, thus costs, continue to rise. 

Source: Irrational Healthcare Payment System Drives Costs And Why Payers Go Along With It | Robert Nelson, MD | LinkedIn

The One Thing… | Robert Nelson, MD | LinkedIn

I contend health plan networks and the multi-industry infrastructure that supports them, are simply a cartel propped up by unwise healthcare policy. They are definitely not part of a healthy functioning free-market.

Look carefully at the characteristics of how health plan networks operate and follow the money flow from start to finish. What holds it all together?  Despite its byzantine complexity and 40+ years of being entrenched into our national psyche, there is one linchpin that holds the whole perverse system together. Any guesses? What’s “The One Thing”?


Source: The One Thing… | Robert Nelson, MD | LinkedIn

It Was the Best of Days and the Worst of Days | Jeffrey Gold | LinkedIn

Jeff Gold

Jeff Gold, MD


Last Wednesday, January 6 2016, was a day I will not forget any time soon. It was a day that showed me the worst of our healthcare system but also the best. The week prior, a new patient enrolled with

Source: It Was the Best of Days and the Worst of Days | Jeffrey Gold | LinkedIn

Be Careful About Replacing ObamaCare

Marilyn Singelton

Marilyn Singelton, MD, JD

…government attempts to mandate healthy behavior don’t work. For example, a 2015 scientific study analyzed the “Los Angeles Fast-Food Ban”, a 2008 zoning regulation restricting opening/remodeling of standalone fast-food restaurants in South Los Angeles. Data showed that consumption of fast food and obesity increased in all geographic areas from 2007 to 2012, and the increase was significantly greater in the regulated area.

Politicians need a “system” to expand central control. Central control breeds mediocrity. Government programs play to the lowest common denominator. One size fits all quickly becomes one size fits none. Call me crazy, but I want the second opinion about my treatment to come from physician, not a government bureaucrat evaluating me from his cubicle.

As Malcolm Gladwell of Tipping Point fame opined, rather than expanding insurance we should keep insurance in its proper role for “unexpected, big-ticket things.” And “the bottom end of healthcare should be a market-driven cash economy.”

Competition brings out the best in us. For example, Theranos, a company started by a Stanford freshman provides 14 accurate basic kidney/liver function tests from one drop of blood for $7.27 at Walgreens. By contrast, my insurance co-pay for lab tests is $40.

Politicians can’t fix our medical care access problems. That’s up to us. As a start, consider enlisting direct pay physicians (here, here, and here) who give personal care at reasonable prices and replace the ACA with your own healthcare system.

Source: Be Careful About Replacing ObamaCare