Insurance ≠ Good Access to Health Care

Do you know what we will see an increase in this fall? Insurance premiums. It’s almost a guaranteed increase you can count on around this time of the year and sadly every year. Just like you can count on trees’ leaves to start falling in fall.

Every fall many people get on the open enrollment page to browse through the health insurance options, which are still often expensive unless they qualify for aid, and often commit to one. Unfortunately many will mistakenly think they are set for the next year in regards to having good, timely access to health care whenever they need it.

We are so accustomed to using insurance that we don’t know any better. If I get a dollar for every time I hear “well that’s a cool concept (upon hearing about dpc for the first time) but I got really good insurance,” I would probably be set for retirement by now. Ok maybe not quite, but it would still make a good sum. Good insurance does not equal good access to medical care. Nor does it mean affordable access to care. Insurance is not health care; insurance is merely health care coverage. Yes, it still does not cover everything nor was it ever meant to. Insurance is meant to be for very costly health expenses. Well, one may ask, then what is health care? What I provide to my patients as a physician is health care. What other physicians and nurses across the country, whether at clinics or hospitals or surgery centers, provide is health care. Many go about their day thinking they have access to health care because they have insurance yet sadly this often isn’t the case. I just happened to read another article today titled ACA leads to Insurance gains, Affordable access to care wanes. Is that a coincidence? Where is the increased cost going to? The access to timely care isn’t necessarily getting any better the next year. This makes you wonder why it keeps getting more expensive.

Another sentence I am starting to hear more frequently as our clinic’s patient panel is growing? It’s often somewhere in the lines of “I didn’t appreciate the level of accessible care I was missing out on despite having insurance all this time until I joined your dpc clinic Dr. Efe”

The good news is that doctors across the nation- there about 1500 or more of us- take the selfless steps (often starting with zero patients) to open primary care clinics using direct care model where a patient literally gets a concierge-like medical care that is unrushed, individualized, comprehensive. Yet, we keep it affordable to give this chance to everyone. If a person can afford a cell phone plan, then can afford good accessible primary care. Not only individuals and families can access to a clinic set up this way, but so can many employees all across the nation. A small business can enroll their employees in a direct primary care clinic and set up a level-funded plan around it. This will deliver greatly accessible, convenient and high quality health care to every single one of their employees, while saving the small businesses a very significant amount of money on health care coverage (up to 30-60%). If you are a business owner currently on a self-funded insurance plan however, please don’t rush to your current insurance broker. They will not want to lose that cut of the ever increasing premiums. Please do your own research. It’s your money, so you should make the decision on whether or not you want to keep throwing away large sums of it year by year while providing unsatisfactory health coverage or whether you want to actually get a good percent of this money back while providing your employees with top of the line concierge like care with an effective insurance planned around it.

Some food for thought. That’s it for now. Have a great weekend


Dr. Efe


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Dr. Efe Sahinoglu, M.D.

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