Mike McGinness, a telecommunications consultant who lives in Kent, has found a way to cut the cost of his family's visits to the doctor by more than half.
Some weeks ago, he says, he'd paid $95 for an appointment with a doctor that lasted maybe 10 minutes.
Then he heard from a friend about SimpleCare, and when his wife and one of his three children got a touch of the flu, he made an appointment with Dr. David McDonald, a SimpleCare member.
Dr. McDonald's charge: $35.
"I think it's absolutely great," says McGinness of saving $60 through SimpleCare.
After SimpleCare got going a few months ago, McDonald began seeing five to 10 new patients a week.
The essence of SimpleCare is this: Physicians discount their prices to people who pay cash for their services. The doctors figure they can afford the discount because they save on the administrative expenses and hassles of dealing with health insurers.
"I could cut my fees in half if there wasn't such a complicated insurance structure or billing requirement," says Dr. Vern Cherewatenko, one of SimpleCare's creators.
SimpleCare is a program put together by a dozen local physicians, alternative care providers and business professionals who recently formed The American Association of Patients and Providers. Physicians can become SimpleCare members by joining the association for $20 a year.
"The program is really just kind of taking off," says Lisa Wiseman, marketing director with HealthMax, a Renton medical wellness company. "We estimate we're seeing 300 to 350 new patients a month."
SimpleCare seems ideal for people who choose to do without health insurance or those who have high-deductible policies.
McGinness, for instance, says he pays Blue Cross of Washington and Alaska about $90 a month for a family policy with a $1,500 deductible. He says a regular policy would cost around $350 a month. With the premium savings, he figures his family can see doctors "seven or eight times a month and break even."
Naturally, he wants to get the most for his money, so he's enthusiastic about SimpleCare.
SimpleCare is partly the creation of McDonald, Cherewatenko and their colleagues at the Primary Care Providers clinic in Renton and at General Medical Clinics, also in Renton. SimpleCare members include River Valley Psychological Services in Tukwila, Dr. Alfred Aflatooni in Bremerton and Dr. Andrew Abolins in Lynnwood.
"SimpleCare is just that -- a simple and affordable way to see a doctor and receive medical care," says Dr. Cherewatenko, who has strong feelings about today's trend toward managed care:
"It's time for the patient and the doctor to take back control of health care, and this program offers a way to do just that."
The way Dr. Cherewatenko sees it, patients and physicians are frustrated and angry with today's complicated arrangements between health insurers and doctors.
"There is so much money spent on frivolous medical administrative expense that half of this money could fund health care for the population in need," he says. "The trillion dollars spent on health care in this country could be cut by at least one third by stepping back and using common sense."
Advocates of a "single-payer" system have railed against America's multiplicity of health insurers and have claimed that the administrative and marketing savings that could be had by making the government the sole insurer would pay for care of the uninsured.
Dr. Cherewatenko agrees that there's a lot of administrative waste, but he's no statist. He's a founder of the American Association of Patients and Providers, whose members believe in the free market and in the sanctity of the physican-patient relationship.
The recently adjourned Legislature passed a bill that changes the way the state Medicaid program pays nursing homes.
Instead of a system based on their facility costs, nursing homes will be paid according to their case mix, which takes into account the needs of individual residents.
"It's time for a system that changes the payments and the dollars to match the needs of patients in skilled nursing facilities," said Rep. Phil Dyer, R-Issaquah. Under the just-enacted bill, HB 2935, reimbursement will increase to nursing homes with sicker patients needing more services.
"This no longer pays for a bed regardless of who is in it," he said.
IDX Systems Corp. of Burlington, Vt., is buying Trego Systems Inc., a Bainbridge Island firm that produces comprehensive contract management systems for integrated delivery networks.
IDX markets health-care information software to medical group practices, health plans and hospitals.