The Future Of Health Care Is Here, If You Know Where To Look

Nearly half of Americans say the healthcare system is failing them. Six in ten report having had a bad healthcare experience. About half of patients say they have trouble affording health care—even those who are insured. All told, Americans’ satisfaction with their healthcare system hit a new low in 2022.

The default response to statistics like these is a call for more government. Indeed, 57% of Americans believe the feds should ensure everyone has health insurance.

But so many of the things that people dislike about health care are consequences of government intervention: pricey insurance, unnecessary waits for care, administrative hassles.

What if we went the other way, and sought a freer market in health care? Technology can make it easier for people to opt out of the healthcare leviathan—and contract directly with doctors on an ongoing basis to secure the care they need at affordable prices.

This sort of one-on-one contracting with doctors is called “direct primary care.” Patients pay a regular subscription fee that runs between $50 and $100 a month, on average, for access to a primary care physician. There’s no third-party billing to an insurer. As a result, direct primary care doctors can be transparent about the cost of additional tests and services. Many direct pay clinics even buy prescription drugs at wholesale prices and dispense them to patients at a discount.

That simple arrangement leaves more time for patient-doctor interaction. Direct pay doctors spend between 30 and 60 minutes per patient, compared to the average mainstream doctor, who can only devote 12 to 15 minutes to each visit.

No wonder direct primary care patients are satisfied with their care. One study found that patients who saw direct primary care doctors reported that their physicians were personable and effective communicators. Another found that direct primary care patients had 25% lower hospital admissions then patients in traditional practices.

One thing that has helped make direct primary care a viable alternative to conventional medicine is the use of telehealth. Direct primary care service provider Hint Health saw a 147% increase in charges for virtual services on its software platform relative to pre-pandemic levels.

Of course, telehealth has taken off among more conventional fee-for-service practices, too. Telehealth use among Medicare enrollees increased 63-fold during the pandemic. And about 90% of patients said they would use telemedicine for non-emergency health services after the pandemic subsided.

It’s not hard to see why. Telehealth is convenient. Patients don’t need to take time off work, commute to an appointment, and wait for their name to be called. All that time spent in transit costs Americans around $89 billion per year.

Virtual visits are also beneficial for the 3.6 million Americans who delay care each year because they can’t get to a doctor’s office. And like direct primary care, telemedicine saves patients money. One study found that patients with respiratory infections spend just $79 per visit on average, compared to $146 for a standard exam.

Reduced prices and wait times do not come at the expense of quality. Studies have shown that telehealth patients have reported better mental and physical health, and that virtual visits led to fewer physician visits and hospital admissions.

Given these benefits, telehealth and direct primary care are projected to boom over the next decade. Some firms, like Teladoc and MDLive, are already household names. Others, like Remote Health Solutions, are just gaining a foothold in the market.

According to Grand View Research, the U.S. telehealth market will be worth more than $300 billion by 2028—up from roughly $34 billion last year.

Direct primary care membership increased 241% nationwide from 2017 to 2021. Over that time, the average age of a direct primary care practice member has dropped from 46 to 40. So young people are embracing the model.

Telemedicine and direct primary care can help patients access affordable, quality care. Taken together, they offer a way out of the costly and confusing status quo—and a vision of what American health care could one day be.