GREEN BAY, WI (WTAQ) – The Wisconsin legislature is debating a bill that would protect direct primary care providers in the state. But what exactly is it, and how is it different than regular healthcare?
Direct primary care essentially allows families to circumvent the complicated health insurance system.
“A family can pay a primary care provider $125 a month, $30 per additional child, for primary care services for the whole family. That includes urgent care and lab work, and there is no insurance middleman,” says Cori Peterson from the Wisconsin Institute for Law & Liberty.
But it’s not only a change for patients. Peterson says it gives doctors less paperwork and more face time with each patient they see.
“Direct primary care providers will see between 600-800 patients per year, while in our current system, they see about 2,000 or so patients,” Peterson says.
While the service of direct primary care can be beneficial for regular visits or even urgent care, Peterson points out that it is exactly what it’s branded – primary care. It also does not qualify as insurance.
“Direct primary care, unlike insurance, they’re not guaranteeing that whatever happens to you is something they’ll cover. There’s no catastrophic coverage, but you can still go to the primary care doctor, you can still go for urgent care,” Peterson tells the WTAQ Morning Show with Matt and Earl.
If there are more serious health problems or emergencies, an individual would be directed to a hospital rather than a primary care facility. A broken leg or a heart attack are likely things the direct primary care provider would not cover.
When it comes down to the final legislative decision to sign off on a measure to support direct primary care, Peterson says the studies show it’s a good system despite some concerns.
“There have been bipartisan studies done – their own research in the legislature says this is what they should be doing,” Peterson says, “some insurance providers have claimed that the consumer protections under direct primary care aren’t what they should be. I believe that’s the hang-up they’re working on right now.”
Direct primary care already exists and is available to everyone in Wisconsin. The red tape is designed to protect the ability to choose coverage through that system.
Direct primary care is currently available in 48 states – and has approximately 250,000 patients nationwide.
