June 17, 2025 • 25 mins
What if the key to fixing our broken healthcare system isn't more policy—but a return to purpose, prevention, and human connection?
In this episode of Opt-Out with Kara Foster, OD, we explore how the world’s healthiest communities—known as the Blue Zones—have achieved extraordinary longevity and wellness, not through high-tech care, but through simple, powerful lifestyle habits. And we connect the dots between these habits and the Direct Care movement: a transparent, relationship-based model that gives doctors time to care and patients the power to heal.
We’ll cover:
What makes Blue Zones different (and what we can borrow from them)
Why Direct Care creates the space for true prevention and connection
A plan to create “pockets of health” in your own town, office, or neighborhood
Healthcare doesn’t have to be confusing or corporate. It can be local. Personal. Transformational.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
Hi friends, and welcome back to Opt Out with Cara Foster, where
we pull back the curtain on the healthcare system, call out
what's not working, and get serious about building something
that does. If you're new here, I'm so glad
you found your way to this space.
I'm Doctor Cara Foster, optometrist, mom, Wellness
advocate, and proud direct care provider.
(00:28):
After spending years inside the traditional insurance system, I
saw first hand how it was hurting my patients, my team,
and my ability to actually care.So I opted out.
Literally. And I created a practice that
puts people over paperwork, quality over quotas, and health
over hustle. Now, I use this podcast to help
(00:49):
other patients and providers do the same by exposing the system
that profits from keeping us sick and showing what it looks
like when we fight back with time, trust, and truth.
Last week, we pulled back the curtain on vision insurance.
We talked about how vision insurance plans aren't really
insurance at all, how they dictate everything from frame
(01:10):
pricing to lab quality, and how they profit from confusion, not
care. If you haven't heard that
episode yet, pause us when I go back because it lays the
foundation for a lot of what we're talking about today.
Today we're shifting gears but staying on mission.
Let me ask you something. What if we stopped waiting for
(01:31):
healthcare to get better and started building something
better right now? Because here's the thing, While
the system that we've all been handed is messy, confusing, and
designed for profit, there are places where healthcare actually
works. Places where people live longer,
where they spend less time in hospitals, where chronic disease
(01:52):
is the exception, not the expectation.
Today's episode is about what wecan learn from those places and
how to bring those principles into our own communities.
We're going to explore 2 powerful, proven ideas.
Direct care. The model that removes insurance
from the room and puts doctors and patients back on the same
team in the Blue Zones, global regions, and now in US towns
(02:17):
where people live well into their 90s and beyond with low
rates of chronic illness. Together, these two models
create what I call pockets of help.
And in a system that profits from keeping people sick, these
pockets are powerful. This isn't just theory, it's a
blueprint. And by the end of today's
episode, you'll have a clear plan on how to apply these ideas
(02:38):
to your practice, your home, andyour community.
Let's get into it. So let's stop pretending that
the system is broken because this might be something that's
hard to hear, but I believe we have to say it out loud.
The healthcare system in this country isn't broken.
It's working exactly the way it was designed to.
(03:00):
That's the problem. See, when people say it's
broken, what they really mean isit's not working for them.
It's not working for us. It's not working for the
patients who can't get answers, the doctors who can't take their
time, or the families drowning in medical debt from trying to
be responsible by going to the doctor.
But the system itself? It's humming along just as
(03:22):
intended, funneling billions of dollars into the pockets of
insurance companies, pharmaceutical giants, and
private equity healthcare groupsthat don't know your name, your
story, or your community. It was never built to heal.
It was built to private. Let's break this down with real
numbers. In the US, we spend nearly $4
trillion a year on healthcare. That's about $12,000 per person
(03:46):
per year, more than any other country by a long shot.
And what do we get for it? More chronic disease, lower life
expectancy, higher maternal mortality, and more people dying
from preventable illness. Why?
Because nearly 90% of that spending, we're talking over
$3.5 trillion people, goes to treating chronic conditions like
(04:11):
heart disease, diabetes, high blood pressure, obesity, and
cancer. But here's the kicker. 80% of
those chronic diseases are preventable. 80% They're not
random. They're not genetic time bombs
waiting to go off. They are the direct result of
lifestyle, environment, food systems, and social stress.
(04:32):
And yet insurance doesn't cover the things that would actually
prevent them. Let me ask you this, can you get
reimbursed for a walking group, A nutrition, plus a 30 minute
visit to talk about how to stop your blood sugar from spiraling?
Nope. But you can get paid for an ER
visit for a diabetic crisis, a foot amputation, a lifetime of
(04:54):
prescription drugs, and multiplefollow-ups once it's too late.
That's not a bug in the system, it's a business model.
Meanwhile, more than half of American adults are already
living with a chronic disease and many don't even know it.
They're walking around with elevated blood pressure, pre
diabetes, insulin resistance, silent inflammation, fatty
(05:16):
liver, things that don't always show up in a rush, 7 minute
visit, and often aren't even screened for until it's already
too late. And you know why we miss it?
Because we don't have time. Doctors don't have time,
patients don't have time to ask real questions, and the system
doesn't give us permission to slow down.
(05:36):
In fact, we're punished for it. If we spend too much time, code
the wrong way, or ask too many lifestyle questions without
available diagnosis, the visit might not get paid at all.
So we check the boxes, we move quickly, and we hope it's
enough. But it's not enough.
And here's the really heavy part.
(05:58):
The system doesn't reward what matters.
It doesn't reward prevention, education, listening, long term
relationships, trust, nutrition,movement, community, sleep,
mental health. What does it reward?
It rewards speed, volume, procedures, prescriptions,
(06:20):
diagnosis and repeat visits. In other words, it rewards
sickness. And when a system financially
thrives, the sicker people get. That's not a system that's
broken. It's a system that's working
exactly as it was designed to, but for someone else.
Not for you, not for your family, not for your patients,
(06:41):
not for your community. And so we have a choice.
We can keep patching holes in a boat that was never seaworthy,
or we can step off that boat andstart building a better vessel
together. A system that slows down,
listens, focuses on root causes,values, time and relationships.
(07:02):
Invests in health before crisis.Builds community purpose and
trust. That's what direct care is.
That's what the Blue Zones show us.
And that's what today's episode is all about.
Because yes, the system is doingwhat it was built to, but we can
do something different. And the blueprint already
(07:22):
exists. When we step outside the
insurance based system, something amazing happens.
We stop treating patients like transactions and we start seeing
them as whole people again. That's what direct care makes
possible. Direct care isn't a workaround
for a broken system. It's a complete reimagining of
(07:44):
what healthcare can be when relationships, trust, and
transparency are put first. Direct care is a healthcare
model that removes insurance companies from the exam room.
Literally. Instead of billing third party
payers, patients pay their doctor directly through clear,
affordable fees, whether that's a monthly membership or
transparent pricing per service.The result is no surprise bills,
(08:06):
no coding games, no middle men telling your doctor how much
time they can spend with you, and no more chasing payments
months after the care was delivered.
What changes for patients? Time, clarity, access and trust.
Appointments go from 7 to 10 minutes to 3045, even 60
(08:27):
minutes, because there's no pressure to see 30 patients a
day just to cover overhead. Instead of reactive rush to
visits, patients get time to tell their story, ask questions
and be heard. And that time makes a huge
difference. Studies show that patients in
direct care models have better outcomes for chronic diseases.
(08:49):
Use the ER and urgent care less often, more likely to follow
through on care plans, and report higher satisfaction and
lower confusion at their appointments.
They're not waiting weeks for their appointments.
They're not trying to decode medical bills after the fact.
They understand what they're paying for and they know their
(09:09):
doctor sees them, not just theirchart will changes for
providers. This is a big one, and it's
personal to me too. Direct care restores a sense of
meaning, freedom and purpose to medical practice.
Without the endless documentation, coding, audits,
underpaid reimbursements. Providers can spend more time
with fewer patients, make decisions based on what's best,
(09:31):
not what's billable, run leaner practices without full time
billing staff, and actually enjoy their work again.
In fact, physicians who've movedto direct primary care
consistently report lower burnout, higher career
satisfaction, more time for their families and their own
health. They're not just practicing
medicine. They're building relationships,
solving problems and preventing illness before it starts.
(09:54):
But what about the data? It's not just feel good
anecdotes. The numbers are there.
A county in North Carolina, my home state, saved 1.2 million in
one year by switching its municipal employees to ADPC
model. Direct care patients are 40 to
60% less likely to visit the ER,and studies show 20% savings and
(10:20):
overall healthcare spending in systems that implement DPC
alongside high deductible plans.This isn't about charging people
more, it's about delivering morefor less cost.
So what does this look like in eye care?
I'm excited about this because we're already starting to apply
the same model and optometry at my direct eye care clinic.
(10:42):
Our pricing is clear, upfront and includes what patients
actually need. Exams are longer and more
thorough. We're not limited by frame
allowances or force lab contracts.
We choose the best products, notthe cheapest.
The insurance companies will reimburse.
And most importantly, we don't rush people through their care
(11:02):
just to survive. Patients leave with glasses they
love, answers they understand and a relationship they can
trust. And when they come back, it's
because they want to, not because they have to.
Check. Check marks on their benefits
box. Why I believe in this model.
After years of working inside the traditional system, I
(11:23):
realized something. If we want to improve health, we
have to rebuild trust. Direct care rebuilds that trust
between patients and providers and even within communities.
It puts the focus back on prevention, education, long term
relationships and human connection.
And as we'll explore next, when you combine that with lessons
(11:46):
from the world's healthiest communities, the Blue Zones, you
get a powerful formula for real,lasting change.
So now that we've talked about what's wrong with the system and
how direct care starts to fix it, let's look at where we want
to go. Because it's not enough to just
stop doing what's broken. We need a blueprint for what
health actually looks like in real life.
(12:08):
And we have one. It's called the Blue Zones.
What are the Blue Zones, you ask?
Blue Zones are regions around the world where people live
longer, healthier lives without hospitals on every corner or
supplement shop in every strip mall.
They were identified by NationalGeographic Explorer and author
Dan Buettner, who worked with researchers and demographers to
pinpoint 5 places with the highest concentrations of people
(12:32):
living past 100 without the chronic diseases that we now
consider normal. The five original Blue Zones are
Okinawa, Japan, Sardinia, Italy,Nicoya Peninsula and Costa Rica,
Acaria, Greece, and Loma Linda, CA.
These aren't places where peopletry to be healthy, they're
places where health is the natural result of how life is
(12:52):
lived day in and day out. Dan identified the Power 99
habits that predict longevity across all the Blue Zones.
They identify 9 common lifestylehabits called the Power 9 that
support happiness, health and longevity #1 is move naturally.
No gyms, just walking, gardening, carrying your
(13:14):
groceries, squatting. Movement is built into their
daily lives #2 is purpose. People have a strong sense of
why I wake up in the morning. This alone is linked to a longer
life. Downshift Stress exists
everywhere, but Blue Zone communities have rituals to
relieve it. Naps prior tea connection.
(13:38):
The 80% rule. They stop eating when they're
80% full, called Harahajibu in Okinawa.
Preventing chronic overeating. 5Plant slant diets are 90 to 95%
whole plant based foods. Beans, greens, grains and nuts
are daily staples. Number six is wine.
(14:02):
Moderate alcohol consumption, especially red wine.
A community not in isolation #7 Is belonging.
Nearly all centenarians belong to a faith-based community or
have some form of spiritual practice #8 Is loved ones first.
Family is central. They keep aging parents nearby
and invest in their children andrelationships #9 is the right
(14:27):
tribe. Their social circles support
healthy behaviors, not sabotage them.
Peer pressure, but the good kind.
So what happens when you bring Blue Zones to the United States?
It's not just a global discovery, It's now a community
transformation movement. Several U.S. cities have adopted
Blue Zone principles through Blue Zone projects, which help
(14:50):
local leaders reshape policies, environments and social norms to
support help. Let's look at Albert Lee,
Minnesota, one of the first BlueZones communities.
In just one year, more than 80 per cent of the residents
increased walking and biking, there was a 40 per cent decrease
in smoking, and 12,000 lbs were lost.
Across the town, employer healthcare costs dropped by 40
(15:13):
per cent. And these changes weren't from a
gym challenge or a temporary faddiet.
They happened because the environment changed.
Sidewalks were added or improved, grocery stores
featured healthier foods at eye level, employers offered walking
and flexible work schedules. Churches and civics groups,
brand purpose workshops and restaurants added plant based
(15:35):
dishes. In short, they made healthy
choice the easy one. The key take away from the Blue
Zones movement is health isn't apersonal responsibility, it's a
community design issue. The average American is not
failing because they lack discipline.
We are living in a system designed for convenience over
nutrition, isolation over connection, speed over slowness,
(15:58):
and short term treatment over a long term prevention.
The Blue Zones show us what's possible when we flip that
script. When communities are designed to
support well-being, health becomes something that happens
to you because it's embedded in your daily life.
So how does this tie to direct care?
This gets exciting for me because direct direct care gives
(16:20):
us the platform to talk about prevention, nutrition, mental
health and lifestyle because we're not rushed or restricted
by insurance. And Blue Zones give us the
playbook for what to do with that time and trust in direct
care. We can recommend beans and not
pills. We can talk about walking, not
just weight loss. And we can guide patients toward
(16:42):
purpose, sleep, stress relief, not just manage symptoms.
And we can build clinics that serve as Wellness hubs, not just
reactive care centers. Together, these two models of
direct care and the Blue Zones create the foundation for
community health that's personal, local, and long
lasting. If you're listening to this and
(17:02):
thinking, wow, I want to see what this looks like in action,
I have a recommendation. Watch the Netflix documentary
series Live to 100. The Secrets of the Blue Zones by
Dan Buettner. Visually rich, heartfelt series
takes you into the daily lives of people living in the world's
healthiest regions, from Okinawato Sardinia.
(17:23):
You'll see how the elders stay active and live well into their
90s and one hundreds. How food, family and community
are seamlessly integrated, and how small changes like eating
beans, walking daily, or findingpurpose add up over decades.
And maybe even more importantly,the final episode of the series
shows us what's happening right here in the US Communities like
(17:46):
Fort Worth, TX, Alberta, Lee, Minnesota are reversing chronic
disease, cutting health costs, and improving quality of life,
all by adopting the blue Blue Zone strategies.
It's inspiring and actionable, and it's one of the most hopeful
things I've seen in the conversation about health in a
long time. So if you want to dive deeper
(18:06):
into the why and the how behind the Blue Zones, grab your
favorite plant based snack and stream live to 100 this weekend.
I think you'll finish it feelingjust like I did.
Ready to start building your ownBlue Zone right where you are?
So how do they work together? Because Direct Care and Blue
Zones don't just coexist, they can amplify each other.
(18:28):
Think of it like this. At their core, both Direct Care
and Blue Zones are built on the same fundamental truth.
Health thrives when people are empowered, not processed.
They share 4 essential pillars. Simplicity.
No billing codes. No pharmaceutical kickbacks.
No 1800 numbers to fight with, just clear real choices and
(18:49):
fewer barriers. They're prevention focused.
In the blue zones. The focus is lifestyle, how you
move, eat, rest and connect, anddirect care.
The focus is time so we can talkabout those things before they
come become disease. Time, trust and purpose.
Whether it's a 45 minute unrushed visit or a long walk
(19:12):
with friends, both models recognize that human
relationships or the foundation of health in rejecting corporate
control. This might sound bold, but it's
true. Neither model is designed to
serve shareholders. They serve people.
Direct care says let's take healthcare back from the
insurance middle men and the Blue Zones say let's take our
(19:34):
health back from the processed food and isolation industrial
complex. Say supplements.
Anyone. Together, that's a revolution.
Direct care removes the administrative clutter that
detracts from care, and the Bluezones remove the lifestyle
clutter that makes disease feel inevitable.
And when you put them together, magic happens.
(19:56):
You get clear upfront cost, no surprise bills.
You get real nutrient dense food, not meds as the first line
treatment. Unrushed visits, space to
breathe, connect to educate. Deep long term relationships
built on trust, not transactions.
A community of support, not justtreatment but transformation.
(20:19):
Direct care gives you the time and freedom to teach with.
The Blue Zones have proven works, and in a system where
most doctors are buried in paperwork and many patients feel
like a number, this combination is the future that we've been
waiting for that we need. Now let's talk about how to make
it actually happen. You don't need to be a city
(20:42):
planner, a policy expert, or a millionaire.
You just need to be willing to take one small step and then
invite others to join you. This is what we're working
towards. If you're a provider, start a
small subscription based patientpanel.
Offer same day or next day appointments, nutritional
counseling, stress support, and upfront pricing.
(21:04):
If you're a patient, seek out a direct care doctor or ask your
current provider if they'd consider starting one.
Many are curious and just need encouragement.
Why does it matter? It reintroduces time, trust and
transparency into the exam room.It shows what care looks like
when it's not rushed, coded or compromised.
(21:25):
It's healthcare with eyes up, not just heads down in the
electronic medical record. To bring Blue Zones local,
here's some actionable steps. Start small, joyful community
events focused around lifestyle medicine.
Host a plant based potluck once a month.
Start a Saturday morning walkinggroup.
(21:46):
Offer a Power 9 challenge for your neighborhood or staff.
Encourage kids to bring grandparents on their walks.
Health isn't created in the clinic.
It's lived in kitchens, on sidewalks, and in conversations.
It's built community while reducing isolation, stress and
chronic disease. And it costs almost nothing.
(22:09):
But measure the outcomes. Track the stuff that really
matters. ER visits, urgent care use,
reduction in prescription medication, patient energy,
mental health and satisfaction, blood pressure, A1C, weight,
relationships, resilience and purpose.
Because data opens doors. It builds trust with funders,
(22:30):
grants, local leaders and your own team.
Show that health doesn't requiremore medication, it requires a
better model. And then tell the story loudly
and often. Write a newsletter to patients.
Post photos of your walking group.
Post town halls and invite city officials.
Speak to students and business leaders.
(22:53):
You can't belt a movement if people don't know it exists.
You're not just offering a service, you're casting a
vision. Remember, most people don't want
more care. They want better care.
We have to show them it's possible.
So my final thought is to start with one step.
You don't have to change your whole town overnight.
(23:14):
Start with a potluck, a conversation, a brave pivot in
your practice. That's how all real change
begins. Because when enough people opt
out of a broken system, togetherwe build something better.
Let's end today with where real change always begins with you.
I know it can feel overwhelming.When we look at the scale of the
(23:36):
system, the trillions of dollars, the mountains of
bureaucracy, lobbyists with unlimited funding, it's easy to
think, who am I to make a difference?
But here's the truth. Change doesn't have to be
national to be powerful. It doesn't have to start with
the law. It can start right here in your
exam room, at your dinner table,on your neighborhood walk, or
(23:58):
around a potluck table in your cul-de-sac.
Because when people understand what's broken, they stop blaming
themselves. And when they see what's
possible, they start helping youbuild it.
Here is what I'd love for you todo.
Share this episode. Send it to your doctor, your
town council, your gym group, your PTA board.
Print it out and hang it in a waiting room.
(24:19):
If your provider. Post it in a Facebook group for
parents, patients, professionals.
Because this is the conversationthat everyone deserves to be a
part of. Reach out if you want help
creating a healthier pocket of your community.
I've got a free PDF I'd love to share with you.
It's called How to Start a Pocket of Health in your
Community. Just e-mail me or leave a
(24:41):
comment and I'll get it to you. Whether you're a teacher, a
coach, a doctor, or just someonewho cares, you're exactly the
person who can lead this change.You have to start where you are.
Host a WHOP, plan a healthy dinner with friends, and ask
your clinic to consider a directcare model.
It doesn't have to be big to be brave, because the system isn't
(25:02):
going to fix itself. But we don't have to wait for it
to. We can build something better
right now. And if this episode helped you
see something more clearly, literally or figuratively, I
hope you'll help me spread the word.
The more patients who opt out ofthe confusion, the closer we get
to a system that works for patients, for providers, and for
(25:23):
the communities that we love. In the next episode, we'll
explore the powerful connection between long term relationships
and well-being from the Harvard Study of Adult Development and
how direct care models make roomfor exactly that continuity,
trust, and genuine connection between patients and providers.
(25:45):
Thanks again for listening. This is Cara Foster opting out.
Hi friends, and welcome back to Opt Out with Cara Foster, where
we pull back the curtain on the healthcare system, call out
what's not working, and get serious about building something
that does. If you're new here, I'm so glad
you found your way to this space.
I'm Doctor Cara Foster, optometrist, mom, Wellness
advocate, and proud direct care provider.
(00:28):
After spending years inside the traditional insurance system, I
saw first hand how it was hurting my patients, my team,
and my ability to actually care.So I opted out.
Literally. And I created a practice that
puts people over paperwork, quality over quotas, and health
over hustle. Now, I use this podcast to help
(00:49):
other patients and providers do the same by exposing the system
that profits from keeping us sick and showing what it looks
like when we fight back with time, trust, and truth.
Last week, we pulled back the curtain on vision insurance.
We talked about how vision insurance plans aren't really
insurance at all, how they dictate everything from frame
(01:10):
pricing to lab quality, and how they profit from confusion, not
care. If you haven't heard that
episode yet, pause us when I go back because it lays the
foundation for a lot of what we're talking about today.
Today we're shifting gears but staying on mission.
Let me ask you something. What if we stopped waiting for
(01:31):
healthcare to get better and started building something
better right now? Because here's the thing, While
the system that we've all been handed is messy, confusing, and
designed for profit, there are places where healthcare actually
works. Places where people live longer,
where they spend less time in hospitals, where chronic disease
(01:52):
is the exception, not the expectation.
Today's episode is about what wecan learn from those places and
how to bring those principles into our own communities.
We're going to explore 2 powerful, proven ideas.
Direct care. The model that removes insurance
from the room and puts doctors and patients back on the same
team in the Blue Zones, global regions, and now in US towns
(02:17):
where people live well into their 90s and beyond with low
rates of chronic illness. Together, these two models
create what I call pockets of help.
And in a system that profits from keeping people sick, these
pockets are powerful. This isn't just theory, it's a
blueprint. And by the end of today's
episode, you'll have a clear plan on how to apply these ideas
(02:38):
to your practice, your home, andyour community.
Let's get into it. So let's stop pretending that
the system is broken because this might be something that's
hard to hear, but I believe we have to say it out loud.
The healthcare system in this country isn't broken.
It's working exactly the way it was designed to.
(03:00):
That's the problem. See, when people say it's
broken, what they really mean isit's not working for them.
It's not working for us. It's not working for the
patients who can't get answers, the doctors who can't take their
time, or the families drowning in medical debt from trying to
be responsible by going to the doctor.
But the system itself? It's humming along just as
(03:22):
intended, funneling billions of dollars into the pockets of
insurance companies, pharmaceutical giants, and
private equity healthcare groupsthat don't know your name, your
story, or your community. It was never built to heal.
It was built to private. Let's break this down with real
numbers. In the US, we spend nearly $4
trillion a year on healthcare. That's about $12,000 per person
(03:46):
per year, more than any other country by a long shot.
And what do we get for it? More chronic disease, lower life
expectancy, higher maternal mortality, and more people dying
from preventable illness. Why?
Because nearly 90% of that spending, we're talking over
$3.5 trillion people, goes to treating chronic conditions like
(04:11):
heart disease, diabetes, high blood pressure, obesity, and
cancer. But here's the kicker. 80% of
those chronic diseases are preventable. 80% They're not
random. They're not genetic time bombs
waiting to go off. They are the direct result of
lifestyle, environment, food systems, and social stress.
(04:32):
And yet insurance doesn't cover the things that would actually
prevent them. Let me ask you this, can you get
reimbursed for a walking group, A nutrition, plus a 30 minute
visit to talk about how to stop your blood sugar from spiraling?
Nope. But you can get paid for an ER
visit for a diabetic crisis, a foot amputation, a lifetime of
(04:54):
prescription drugs, and multiplefollow-ups once it's too late.
That's not a bug in the system, it's a business model.
Meanwhile, more than half of American adults are already
living with a chronic disease and many don't even know it.
They're walking around with elevated blood pressure, pre
diabetes, insulin resistance, silent inflammation, fatty
(05:16):
liver, things that don't always show up in a rush, 7 minute
visit, and often aren't even screened for until it's already
too late. And you know why we miss it?
Because we don't have time. Doctors don't have time,
patients don't have time to ask real questions, and the system
doesn't give us permission to slow down.
(05:36):
In fact, we're punished for it. If we spend too much time, code
the wrong way, or ask too many lifestyle questions without
available diagnosis, the visit might not get paid at all.
So we check the boxes, we move quickly, and we hope it's
enough. But it's not enough.
And here's the really heavy part.
(05:58):
The system doesn't reward what matters.
It doesn't reward prevention, education, listening, long term
relationships, trust, nutrition,movement, community, sleep,
mental health. What does it reward?
It rewards speed, volume, procedures, prescriptions,
(06:20):
diagnosis and repeat visits. In other words, it rewards
sickness. And when a system financially
thrives, the sicker people get. That's not a system that's
broken. It's a system that's working
exactly as it was designed to, but for someone else.
Not for you, not for your family, not for your patients,
(06:41):
not for your community. And so we have a choice.
We can keep patching holes in a boat that was never seaworthy,
or we can step off that boat andstart building a better vessel
together. A system that slows down,
listens, focuses on root causes,values, time and relationships.
(07:02):
Invests in health before crisis.Builds community purpose and
trust. That's what direct care is.
That's what the Blue Zones show us.
And that's what today's episode is all about.
Because yes, the system is doingwhat it was built to, but we can
do something different. And the blueprint already
(07:22):
exists. When we step outside the
insurance based system, something amazing happens.
We stop treating patients like transactions and we start seeing
them as whole people again. That's what direct care makes
possible. Direct care isn't a workaround
for a broken system. It's a complete reimagining of
(07:44):
what healthcare can be when relationships, trust, and
transparency are put first. Direct care is a healthcare
model that removes insurance companies from the exam room.
Literally. Instead of billing third party
payers, patients pay their doctor directly through clear,
affordable fees, whether that's a monthly membership or
transparent pricing per service.The result is no surprise bills,
(08:06):
no coding games, no middle men telling your doctor how much
time they can spend with you, and no more chasing payments
months after the care was delivered.
What changes for patients? Time, clarity, access and trust.
Appointments go from 7 to 10 minutes to 3045, even 60
(08:27):
minutes, because there's no pressure to see 30 patients a
day just to cover overhead. Instead of reactive rush to
visits, patients get time to tell their story, ask questions
and be heard. And that time makes a huge
difference. Studies show that patients in
direct care models have better outcomes for chronic diseases.
(08:49):
Use the ER and urgent care less often, more likely to follow
through on care plans, and report higher satisfaction and
lower confusion at their appointments.
They're not waiting weeks for their appointments.
They're not trying to decode medical bills after the fact.
They understand what they're paying for and they know their
(09:09):
doctor sees them, not just theirchart will changes for
providers. This is a big one, and it's
personal to me too. Direct care restores a sense of
meaning, freedom and purpose to medical practice.
Without the endless documentation, coding, audits,
underpaid reimbursements. Providers can spend more time
with fewer patients, make decisions based on what's best,
(09:31):
not what's billable, run leaner practices without full time
billing staff, and actually enjoy their work again.
In fact, physicians who've movedto direct primary care
consistently report lower burnout, higher career
satisfaction, more time for their families and their own
health. They're not just practicing
medicine. They're building relationships,
solving problems and preventing illness before it starts.
(09:54):
But what about the data? It's not just feel good
anecdotes. The numbers are there.
A county in North Carolina, my home state, saved 1.2 million in
one year by switching its municipal employees to ADPC
model. Direct care patients are 40 to
60% less likely to visit the ER,and studies show 20% savings and
(10:20):
overall healthcare spending in systems that implement DPC
alongside high deductible plans.This isn't about charging people
more, it's about delivering morefor less cost.
So what does this look like in eye care?
I'm excited about this because we're already starting to apply
the same model and optometry at my direct eye care clinic.
(10:42):
Our pricing is clear, upfront and includes what patients
actually need. Exams are longer and more
thorough. We're not limited by frame
allowances or force lab contracts.
We choose the best products, notthe cheapest.
The insurance companies will reimburse.
And most importantly, we don't rush people through their care
(11:02):
just to survive. Patients leave with glasses they
love, answers they understand and a relationship they can
trust. And when they come back, it's
because they want to, not because they have to.
Check. Check marks on their benefits
box. Why I believe in this model.
After years of working inside the traditional system, I
(11:23):
realized something. If we want to improve health, we
have to rebuild trust. Direct care rebuilds that trust
between patients and providers and even within communities.
It puts the focus back on prevention, education, long term
relationships and human connection.
And as we'll explore next, when you combine that with lessons
(11:46):
from the world's healthiest communities, the Blue Zones, you
get a powerful formula for real,lasting change.
So now that we've talked about what's wrong with the system and
how direct care starts to fix it, let's look at where we want
to go. Because it's not enough to just
stop doing what's broken. We need a blueprint for what
health actually looks like in real life.
(12:08):
And we have one. It's called the Blue Zones.
What are the Blue Zones, you ask?
Blue Zones are regions around the world where people live
longer, healthier lives without hospitals on every corner or
supplement shop in every strip mall.
They were identified by NationalGeographic Explorer and author
Dan Buettner, who worked with researchers and demographers to
pinpoint 5 places with the highest concentrations of people
(12:32):
living past 100 without the chronic diseases that we now
consider normal. The five original Blue Zones are
Okinawa, Japan, Sardinia, Italy,Nicoya Peninsula and Costa Rica,
Acaria, Greece, and Loma Linda, CA.
These aren't places where peopletry to be healthy, they're
places where health is the natural result of how life is
(12:52):
lived day in and day out. Dan identified the Power 99
habits that predict longevity across all the Blue Zones.
They identify 9 common lifestylehabits called the Power 9 that
support happiness, health and longevity #1 is move naturally.
No gyms, just walking, gardening, carrying your
(13:14):
groceries, squatting. Movement is built into their
daily lives #2 is purpose. People have a strong sense of
why I wake up in the morning. This alone is linked to a longer
life. Downshift Stress exists
everywhere, but Blue Zone communities have rituals to
relieve it. Naps prior tea connection.
(13:38):
The 80% rule. They stop eating when they're
80% full, called Harahajibu in Okinawa.
Preventing chronic overeating. 5Plant slant diets are 90 to 95%
whole plant based foods. Beans, greens, grains and nuts
are daily staples. Number six is wine.
(14:02):
Moderate alcohol consumption, especially red wine.
A community not in isolation #7 Is belonging.
Nearly all centenarians belong to a faith-based community or
have some form of spiritual practice #8 Is loved ones first.
Family is central. They keep aging parents nearby
and invest in their children andrelationships #9 is the right
(14:27):
tribe. Their social circles support
healthy behaviors, not sabotage them.
Peer pressure, but the good kind.
So what happens when you bring Blue Zones to the United States?
It's not just a global discovery, It's now a community
transformation movement. Several U.S. cities have adopted
Blue Zone principles through Blue Zone projects, which help
(14:50):
local leaders reshape policies, environments and social norms to
support help. Let's look at Albert Lee,
Minnesota, one of the first BlueZones communities.
In just one year, more than 80 per cent of the residents
increased walking and biking, there was a 40 per cent decrease
in smoking, and 12,000 lbs were lost.
Across the town, employer healthcare costs dropped by 40
(15:13):
per cent. And these changes weren't from a
gym challenge or a temporary faddiet.
They happened because the environment changed.
Sidewalks were added or improved, grocery stores
featured healthier foods at eye level, employers offered walking
and flexible work schedules. Churches and civics groups,
brand purpose workshops and restaurants added plant based
(15:35):
dishes. In short, they made healthy
choice the easy one. The key take away from the Blue
Zones movement is health isn't apersonal responsibility, it's a
community design issue. The average American is not
failing because they lack discipline.
We are living in a system designed for convenience over
nutrition, isolation over connection, speed over slowness,
(15:58):
and short term treatment over a long term prevention.
The Blue Zones show us what's possible when we flip that
script. When communities are designed to
support well-being, health becomes something that happens
to you because it's embedded in your daily life.
So how does this tie to direct care?
This gets exciting for me because direct direct care gives
(16:20):
us the platform to talk about prevention, nutrition, mental
health and lifestyle because we're not rushed or restricted
by insurance. And Blue Zones give us the
playbook for what to do with that time and trust in direct
care. We can recommend beans and not
pills. We can talk about walking, not
just weight loss. And we can guide patients toward
(16:42):
purpose, sleep, stress relief, not just manage symptoms.
And we can build clinics that serve as Wellness hubs, not just
reactive care centers. Together, these two models of
direct care and the Blue Zones create the foundation for
community health that's personal, local, and long
lasting. If you're listening to this and
(17:02):
thinking, wow, I want to see what this looks like in action,
I have a recommendation. Watch the Netflix documentary
series Live to 100. The Secrets of the Blue Zones by
Dan Buettner. Visually rich, heartfelt series
takes you into the daily lives of people living in the world's
healthiest regions, from Okinawato Sardinia.
(17:23):
You'll see how the elders stay active and live well into their
90s and one hundreds. How food, family and community
are seamlessly integrated, and how small changes like eating
beans, walking daily, or findingpurpose add up over decades.
And maybe even more importantly,the final episode of the series
shows us what's happening right here in the US Communities like
(17:46):
Fort Worth, TX, Alberta, Lee, Minnesota are reversing chronic
disease, cutting health costs, and improving quality of life,
all by adopting the blue Blue Zone strategies.
It's inspiring and actionable, and it's one of the most hopeful
things I've seen in the conversation about health in a
long time. So if you want to dive deeper
(18:06):
into the why and the how behind the Blue Zones, grab your
favorite plant based snack and stream live to 100 this weekend.
I think you'll finish it feelingjust like I did.
Ready to start building your ownBlue Zone right where you are?
So how do they work together? Because Direct Care and Blue
Zones don't just coexist, they can amplify each other.
(18:28):
Think of it like this. At their core, both Direct Care
and Blue Zones are built on the same fundamental truth.
Health thrives when people are empowered, not processed.
They share 4 essential pillars. Simplicity.
No billing codes. No pharmaceutical kickbacks.
No 1800 numbers to fight with, just clear real choices and
(18:49):
fewer barriers. They're prevention focused.
In the blue zones. The focus is lifestyle, how you
move, eat, rest and connect, anddirect care.
The focus is time so we can talkabout those things before they
come become disease. Time, trust and purpose.
Whether it's a 45 minute unrushed visit or a long walk
(19:12):
with friends, both models recognize that human
relationships or the foundation of health in rejecting corporate
control. This might sound bold, but it's
true. Neither model is designed to
serve shareholders. They serve people.
Direct care says let's take healthcare back from the
insurance middle men and the Blue Zones say let's take our
(19:34):
health back from the processed food and isolation industrial
complex. Say supplements.
Anyone. Together, that's a revolution.
Direct care removes the administrative clutter that
detracts from care, and the Bluezones remove the lifestyle
clutter that makes disease feel inevitable.
And when you put them together, magic happens.
(19:56):
You get clear upfront cost, no surprise bills.
You get real nutrient dense food, not meds as the first line
treatment. Unrushed visits, space to
breathe, connect to educate. Deep long term relationships
built on trust, not transactions.
A community of support, not justtreatment but transformation.
(20:19):
Direct care gives you the time and freedom to teach with.
The Blue Zones have proven works, and in a system where
most doctors are buried in paperwork and many patients feel
like a number, this combination is the future that we've been
waiting for that we need. Now let's talk about how to make
it actually happen. You don't need to be a city
(20:42):
planner, a policy expert, or a millionaire.
You just need to be willing to take one small step and then
invite others to join you. This is what we're working
towards. If you're a provider, start a
small subscription based patientpanel.
Offer same day or next day appointments, nutritional
counseling, stress support, and upfront pricing.
(21:04):
If you're a patient, seek out a direct care doctor or ask your
current provider if they'd consider starting one.
Many are curious and just need encouragement.
Why does it matter? It reintroduces time, trust and
transparency into the exam room.It shows what care looks like
when it's not rushed, coded or compromised.
(21:25):
It's healthcare with eyes up, not just heads down in the
electronic medical record. To bring Blue Zones local,
here's some actionable steps. Start small, joyful community
events focused around lifestyle medicine.
Host a plant based potluck once a month.
Start a Saturday morning walkinggroup.
(21:46):
Offer a Power 9 challenge for your neighborhood or staff.
Encourage kids to bring grandparents on their walks.
Health isn't created in the clinic.
It's lived in kitchens, on sidewalks, and in conversations.
It's built community while reducing isolation, stress and
chronic disease. And it costs almost nothing.
(22:09):
But measure the outcomes. Track the stuff that really
matters. ER visits, urgent care use,
reduction in prescription medication, patient energy,
mental health and satisfaction, blood pressure, A1C, weight,
relationships, resilience and purpose.
Because data opens doors. It builds trust with funders,
(22:30):
grants, local leaders and your own team.
Show that health doesn't requiremore medication, it requires a
better model. And then tell the story loudly
and often. Write a newsletter to patients.
Post photos of your walking group.
Post town halls and invite city officials.
Speak to students and business leaders.
(22:53):
You can't belt a movement if people don't know it exists.
You're not just offering a service, you're casting a
vision. Remember, most people don't want
more care. They want better care.
We have to show them it's possible.
So my final thought is to start with one step.
You don't have to change your whole town overnight.
(23:14):
Start with a potluck, a conversation, a brave pivot in
your practice. That's how all real change
begins. Because when enough people opt
out of a broken system, togetherwe build something better.
Let's end today with where real change always begins with you.
I know it can feel overwhelming.When we look at the scale of the
(23:36):
system, the trillions of dollars, the mountains of
bureaucracy, lobbyists with unlimited funding, it's easy to
think, who am I to make a difference?
But here's the truth. Change doesn't have to be
national to be powerful. It doesn't have to start with
the law. It can start right here in your
exam room, at your dinner table,on your neighborhood walk, or
(23:58):
around a potluck table in your cul-de-sac.
Because when people understand what's broken, they stop blaming
themselves. And when they see what's
possible, they start helping youbuild it.
Here is what I'd love for you todo.
Share this episode. Send it to your doctor, your
town council, your gym group, your PTA board.
Print it out and hang it in a waiting room.
(24:19):
If your provider. Post it in a Facebook group for
parents, patients, professionals.
Because this is the conversationthat everyone deserves to be a
part of. Reach out if you want help
creating a healthier pocket of your community.
I've got a free PDF I'd love to share with you.
It's called How to Start a Pocket of Health in your
Community. Just e-mail me or leave a
(24:41):
comment and I'll get it to you. Whether you're a teacher, a
coach, a doctor, or just someonewho cares, you're exactly the
person who can lead this change.You have to start where you are.
Host a WHOP, plan a healthy dinner with friends, and ask
your clinic to consider a directcare model.
It doesn't have to be big to be brave, because the system isn't
(25:02):
going to fix itself. But we don't have to wait for it
to. We can build something better
right now. And if this episode helped you
see something more clearly, literally or figuratively, I
hope you'll help me spread the word.
The more patients who opt out ofthe confusion, the closer we get
to a system that works for patients, for providers, and for
(25:23):
the communities that we love. In the next episode, we'll
explore the powerful connection between long term relationships
and well-being from the Harvard Study of Adult Development and
how direct care models make roomfor exactly that continuity,
trust, and genuine connection between patients and providers.
(25:45):
Thanks again for listening. This is Cara Foster opting out.
Popular Podcasts
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.