That’s supposed to be one of the driving forces behind the push to nationalize health care.  What happens when physicians attempt to do that in their own practices?  The government shuts them down:  State regulators grapple with doctors’ flat fees

Veteran doctor John Muney says his flat-fee, $79-a-month medical service is a formula for making health care affordable and patient-friendly. But state regulators see it as self-styled insurance and have told him to shut it down.

The dispute, which emerged this month, reflects a rising issue in what is sometimes called “retainer” medical care. At least two other states have grappled with whether to consider such arrangements insurance, reaching different conclusions.

What do patients get for their $79?  Basically, preventive care:

The monthly fee buys unlimited office visits, including certain tests and in-office surgeries and even a prescription-discount card. It doesn’t cover treatment requiring hospitalization or specialized care.

What’s the problem with this?  Fewer doctors will join government-approved insurance networks and the government will lose out on licensing fees:

…Critics fear they siphon much-needed primary care doctors from insurance networks and raise questions about equity – especially models that promise to make doctors more available to the fee-paying patients. The American Medical Association says retainer practices raise ethical concerns but also expand health care options.

…AMG’s Web site declares the arrangement isn’t insurance, but the Insurance Department says it meets the definition: charging a regular fee to provide a benefit in case of an unforeseen event, such as an illness or injury. Insurers are required to submit to a licensing process that examines their finances and capacity to deliver what they promise.

Maryland decided this kind of arrangement may or may not constitute an insurance plan, depending on what services are included.  Washington State decided that since this kind of program involves only primary care, it doesn’t constitute insurance.  Florida allows it, and has a group that “provides extensive preventive care for $1,500 a year,” and” has grown into a 300-physician, 100,000-patient network in nine years.”

It seems a lot of people like this arrangement.  And if President Obama and Congress are truly looking to reform the system for the benefit of patients, they should look into removing obstacles in the way of private businesses.

Thanks to NetRightNation