November 12, 2024 • 19 mins
WHAT CHANGES COULD BE COMING TO HEALTHCARE? I'm talking today with the President and Chief Experience Officer of Pinnacle Advanced Primary Care Travis Bockenstedt about what a new Trump administration could mean for healthcare. If you need affordable healthcare for yourself of your small business contact Travis at Pinnacle Advanced Primary Care can help by clicking here.
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Episode Transcript
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Speaker 1 (00:00):
One of my smartest guests making a return appearance. He's
(00:03):
the President and Chief Experience Officer of Pinnacle Advanced Primary Care,
a phenomenal direct primary care organization that is really helping
demonstrate how free market solutions can be the answer to
our healthcare situation.
Speaker 2 (00:18):
Travis, welcome back to the show.
Speaker 3 (00:20):
First of all, thank you, Mandy, so excited to be back.
Speaker 2 (00:23):
Well, we have a lot to talk about.
Speaker 1 (00:25):
And I always say I don't know anybody else who
knows more about healthcare and the delivery systems than you do,
because you consume this like water out of a fire hose.
And we're here today to talk about the fact we've
got a new administration, well new old administration coming.
Speaker 2 (00:45):
Back under the Trump administration.
Speaker 1 (00:47):
And in the first go round, Trump tried to repeal
Obamacare and failed again. The Republicans have failed multiple times
to repeal Obamacare. And I could argue pretty convincingly I
think that Obamacare has done nothing but drive up the
cost of healthcare in this country.
Speaker 2 (01:05):
Nobody is paying.
Speaker 1 (01:06):
Less unless they are on a subsidized plan than they
were before Obamacare. The care is not as good, the
premiums are more expensive, the out of pocket costs are ginormous,
but there's got to be a way to take what
you guys are doing and check market forces in And
I think that the Trump administration has indicated through Speaker
(01:28):
Mike Johnson, that they are looking to make some serious
changes to Obamacare, giving up the notion of repealing it.
But that means because Obamacare is like this giant umbrella
over all of our healthcare right now, that changes to
Obamacare will definitely have an impact on people and on market.
(01:49):
So what are your thoughts about where we are now
and what may or may not because no real policy
positions have been put forward, But what do you think
some of these changes might look like? How concerned should
people be about what's coming?
Speaker 4 (02:04):
So, first and foremost, Obamacare is It's a monster, right,
It is an onion that is never ending. And I
spent three days in Washington, DC in September on the
Hill pummeling politicians with questions about healthcare, and they all
seem to dodge it on both sides. And then you
talk to your friends and family about healthcare who are
(02:24):
really unhappy with it, but they dodge the questions that
don't want to change it. So what I think we
will see next year is that through the new administration,
there could be more choice, and it may require more
involvement from the healthcare consumer. At the end of the day,
if we want to change the healthcare system, we're going
(02:46):
to have to start looking at things in.
Speaker 3 (02:49):
Places and organizations that are doing it right.
Speaker 4 (02:51):
Anytime you talk about free market healthcare to people, I
get a glazed overlook because they have no idea what
that means. We can't dismantle the whole healthcare system overnight.
We need solutions, And when I was sending you text messages,
I'm like, Mandy, I'm not hearing about any solutions.
Speaker 2 (03:09):
Yeah.
Speaker 4 (03:10):
So what I would say to my Republican colleagues and
friends and conservatives is that we need to identify something
that's working. Direct primary care is a current healthcare movement
that is alive and rich here in Colorado, where family
physicians are saying good riddance to insurance and creating a
cash pay system for their patients and clients to do
a direct cash transaction with their family doctor. If you
(03:32):
have listeners who are sixty plus years old, they will
remember this.
Speaker 3 (03:36):
They will know what this is like.
Speaker 4 (03:38):
So we need to just start talking about actual solutions
that are happening.
Speaker 1 (03:43):
Well, you know, I, for a long time, and I
mean a long time, perhaps the entire twenty years that
I've been on the radio, have advocated for some system
that looks like this. We have two kinds of health care.
We have emergency health care, which is you have a
heart attack, they put you in the back of the ambulance,
you go to the hospital wherever they take you. And
that's one kind of healthcare. Injecting market forces into that
(04:06):
is challenging because it is a spur.
Speaker 2 (04:08):
Of the moment.
Speaker 1 (04:09):
You don't have time to call around, Hey, what does
a HEARTCAF cost at your hospital? That needs to be
dealt with with insurance. Right, that's where insurance comes into play.
You're basically insuring yourself against catastrophic losses for an emergency.
But all of the other things that I call this
scheduled healthcare, when I go in for a checkup, when
I go in to have my hip replaced, when I
(04:31):
go in anything that I am putting on the schedule myself.
There is no reason why we cannot inject market forces
into that part of the equation. And I think, and
I don't know, I'm pretty sure that a vast majority
of our health care is delivered in that fashion, right
it is people go into the doctor when they have
the flu, or they just need a check up, or
(04:52):
they need a sports physical for their kids. That is
the vast majority of healthcare is delivered in that way.
So that's what I've been advocating for. And that's one
of the reasons that I love direct primary care because
it is in a way free market choices. You go
and say, look, I don't want to pay an insane
premium with a ten thousand dollars deductible for my family
(05:14):
and not be able to get healthcare because if I
have to pay the first ten grand I don't have that.
Whereas with direct primary care, you sign up, you sign up,
you basically join the club. It's a membership program, and
then you're only paying wholesale pricing on the tests and
stuff like that. That if you go through your doctor,
they're going to not just charge you whlesale pricing in
(05:36):
that price is going to be the people that manage
the insurance, the pass through all of these other costs.
So it can be done. You guys are doing it.
What is going to have to happen in your view
or is there kind of a one view of how
to make that a nationwide proposition. Are people too married
to the concept of my insurance is going to pay
(05:57):
for it before they're willing to say, wait a minute,
if I did this, I would actually save money in
the long run.
Speaker 3 (06:04):
Yeah.
Speaker 4 (06:04):
We absolutely have an addiction to health insurance and we
are using it improperly. I was shopping around for tires
today for my car. I did not call Progressive and say, hey,
I want you to pay for my tires, because it
would go from a seven hundred dollars bill and all
of a sudden, my tires would cost ten grand. Right,
but tires are affordable because it's a free market where
(06:27):
you can go shopping. I think what scares the consumer
is we have not empowered them with any sort of
model that promotes the idea of shopping around. And for
some foremost working on preventive healthcare, we have created a
sick care system the United States that makes money off
of sick people. Right, because getting to your family doctor
(06:49):
is a six month ordeal. They're never going to get
you in, so you end up in the ear and
urgent care for your care.
Speaker 3 (06:55):
What we're saying is.
Speaker 4 (06:57):
Let's start with restoring primary care in family medicine. Let's
make sure everybody has access to a good family doctor
that they can reach when something is going on. Good
family health care can take care of ninety percent of
your everyday health and wellness needs. So we need to
start looking and saying, hey, let's fix this first. We're
(07:17):
looking at a shortage of fifty thousand primary care physicians
in the next decade if we do not fix something.
Seeing thirty to forty patients a day is not fun,
and doctors don't want to do that. In direct primary care,
they're seeing six to ten patients a day for about
forty minutes apiece.
Speaker 3 (07:36):
How do we do that.
Speaker 4 (07:38):
We have changed the financing model for our practice. No insurance,
no government kickbacks, no subsidies, none of it. If we
did those things, it would cost forty percent more to
go to our practice.
Speaker 1 (07:51):
Holy crap, it's that much. Just the bureaucracy it costs
forty percent more.
Speaker 3 (07:58):
So imagine this. Sixty nine thousand ICD ten codes. People
think that.
Speaker 2 (08:04):
Your health What is an ICD ten code? What is that?
Speaker 4 (08:07):
So you talk about your elbow, there's a code for that.
You talk, you have a complaint about your in laws.
There's actually a code for that.
Speaker 2 (08:15):
Shut up.
Speaker 4 (08:17):
No, not at all, because your medical record, yes it's
a medical record, but it is a billing document at
the end of the day. Our practice accepted insurance, forty
percent of our revenue would.
Speaker 3 (08:30):
Go to sending you a bill at the end of
the day.
Speaker 4 (08:32):
So if we cut that mess out and say, hey, Mandy,
if you just want to take cash to your doctor,
it's kind of like cost go for healthcare, right, you
have a membership and you're getting everything out.
Speaker 3 (08:43):
A wholesale cost.
Speaker 4 (08:44):
We dropped a lab cost for a woman from eight
hundred dollars same local lab. We negotiated cash paid to
the same lab for forty nine bucks.
Speaker 2 (08:53):
Oh my god.
Speaker 1 (08:54):
That is that is just I mean, that's I think
part of the problem, Travis, is that the medical services,
and traditionally are medical services, the pricing is completely opaque, like.
Speaker 3 (09:07):
We have no idea.
Speaker 1 (09:08):
You go to the when I was told and I've
told this story before, and I think I've told it
to you before. When I went in ten years ago,
before I did regenerative medicine on my knee, and an
orthopedis said, well, you need to get an MRI, and
I just out of curiosity, said, well, how much does
an MRI cost? And he said to me, well, it
depends on your insurance. I go, but what does it cost?
(09:28):
And he had no idea, no clue whatsoever. And he's
the physician saying I need to have this, but even
he had absolutely no idea.
Speaker 2 (09:38):
How much it cost.
Speaker 1 (09:39):
And I thought to myself, that's a huge part of
the issue, right, is that everything is so opaque. We
don't know how much things cost. And even if you can,
I don't know if you've gone to the hospital listing
of pricing, it's absurd. It is so dense and hard
to read. If you do not know, if you're not
a medical biller, you have no idea what's in those
(10:00):
They've made it, I think on purpose. They've made it
horribly challenging to figure out how much something is going
to cost so you can make a decision about whether
or not to have that test or procedure. And a
lot of times those tests or procedures are only ordered
as a cya for the doctor for legal purposes. And
I don't blame them. This is the game they have
(10:22):
to play. But there's so much waste in the medical system.
Speaker 3 (10:26):
There is a vast majority of it. It's actually waste.
Speaker 4 (10:29):
And I don't want to use this position's name to
protect their privacy, but I had a conversation with them
and said, what was your tipping point in getting out
of this mess and going into a direct primary care practice?
Speaker 3 (10:39):
And they said, you know what.
Speaker 4 (10:40):
Travis was working in rural medicine and a hospital CEO
sat us all down and said, I need you to
order more MRIs and he goes why, And I'm paraphraming this,
paraphrasing this, but it was basically like, if you want
a paycheck, you will order more MRIs and it's not medically.
Speaker 3 (10:58):
Necessary to do.
Speaker 4 (11:00):
If any of you have ended up in the er unfortunately,
or urgent care you have so much blood taking out
of you, they do all the scans possible because it's
bill bill bill right, And unfortunately, we have a bloated
system that relies on one person paying ten thousand for
their replacement and the other person paying one hundred. It
(11:20):
would be insane if we pulled up to a McDonald's,
got a burger, got to the window and they said,
a Mandy.
Speaker 3 (11:26):
No bill for you today, and you're like.
Speaker 4 (11:28):
Really, and they're like, yeah, based on your insurance or
your food company, whatever, we'll send you the bill later.
And your McDonald's cheeseburger is now ten thousand dollars, but
the guy behind you paid by right.
Speaker 3 (11:39):
That is insanity.
Speaker 4 (11:40):
We would never allow that in any other system, but
we allow it in the most personal buying decision we make,
and that is healthcare.
Speaker 1 (11:47):
So there's a couple of things that I would like
to see, and one of them may come true sooner
rather than later, and that is Biden expanded the Obamacare
subsidies and they expanded them to four times the poverty level.
And there's a lot of people who are taking advantage
of that, meaning they are taking taxpayer dollars to subsidize
their health insurance premiums. Now, I don't want people to
(12:09):
be without health insurance, but the more people that we
take out of the pain point, the less people there
are to advocate for a significant change to the system.
But Travis, I think we are seeing now the government
is reacting because now the government has made an edict
that if you are a Medicare, if you are a
doctor who accepts Medicare, and all of a sudden, you're
(12:31):
not taking that anymore, as someone on Medicare can no
longer cash pay for physicians or there. I mean, think
about that for a second. Somebody says, look, I just
want to I want to cash pay for this.
Speaker 2 (12:42):
I'm going to pay for it out of my own pocket.
Speaker 1 (12:44):
The government has said no, you are not allowed to
accept cash payments from patients who want to work outside
the system. That to me says they know the system
is jacked up, but they have to keep us all
in it in order to keep it moving forward and
make sure that everybody's pockets are getting lined.
Speaker 3 (13:00):
No, that's absolutely true.
Speaker 4 (13:01):
There's a few bills out right now that would expand
direct primary care to veterans.
Speaker 2 (13:06):
Oh wow, that would be fantastic.
Speaker 3 (13:07):
It would be huge because we know they have access issues.
Speaker 4 (13:10):
And if forty minutes to an hour to spend with
a veteran, think about how many things you could talk through.
Then we've got the medicaid situation you were talking about.
Speaker 3 (13:19):
In the state of Colorado.
Speaker 4 (13:21):
Cannot electively choose to go to our practice or we
could get in trouble, and so could the Medicaid recipient.
I'm not asking for Medicaid dollars. I'm asking for that
Medicaid recipient to have a choice in their care, and
then hsas why can you not use your HSA monies
to pay for a direct primary care membership can do that. So, yes,
(13:43):
the system is rigged in a way that does not
allow innovation to happen. But this is precisely what we
need to start to fix our healthcare system.
Speaker 1 (13:53):
What I think is a very interesting proposal. I can't
wait to see if RFK Junior ends up as the
secretary or some role at Health and Human Services because
there are things that he wants to do, specifically taking
drug ads off television that I think would be a
game changer for just medicine overall, because so many doctors
(14:16):
are having patients come in and say, oh, I want
to try this medication.
Speaker 2 (14:19):
It's the newest, most expensive.
Speaker 1 (14:21):
There are so many ways that our system is distorted,
absolutely distorted, Travis, I got to share some of these
because now there's a couple of them that have come in,
specifically about Pinnacle.
Speaker 2 (14:32):
I love Pinnacle.
Speaker 1 (14:32):
Doctor Dygert actually spends time with you and you don't
feel like you're being pushed out the door.
Speaker 2 (14:37):
Through Pinnacle.
Speaker 1 (14:38):
My echo cardiogram costs less than two hundred bucks. I
was quoted over five thousand from a normal provider. It's working,
it's happening. I don't know what else we can do
to support freedom in healthcare decisions, but we've got to
allow people to opt out of a system that is
geared to your point to run up billing. I got
(15:02):
to tell you, I think the main reason that the
medical community has endorsed the medicalization of children who are
gender dysphoric is because one of those patients is worth
well over several million dollars over their lifetime as a
medical patient. That is horrifying, but there's been too many
(15:23):
medical professionals who have said some variation of that for
me to ignore it. We have to take that incentive
out of medicine and just help people understand what there
is that's different or new or or options that they
have to make a different choice. And that's really what
(15:44):
it's all about, like let us choose.
Speaker 2 (15:46):
Our own stuff.
Speaker 4 (15:47):
Let us choose our own stuff and take a step back.
I want your listeners to take a step back and
go every single thing we have the government do for
us for our healthcare.
Speaker 3 (15:56):
They can take away.
Speaker 4 (15:58):
Correct administration anytime, can change it up. I'm asking people
to own your primary care experience.
Speaker 3 (16:06):
Put your money where your mouth is.
Speaker 4 (16:08):
Support a local physician in your community. We have ninety
of them across the state of Colorado, ninety independent physicians
doing this.
Speaker 3 (16:17):
Put your money where your mouth is. I don't care
if you have the Platinum insurance.
Speaker 4 (16:20):
Plan, invest in a local solution, keep your Platinum plan.
Speaker 3 (16:24):
I don't care.
Speaker 4 (16:25):
We just know that next year it might change and
your doctor may go out of network. But you own
your Pinnacle membership as long as you pay it well.
Speaker 2 (16:34):
Travis, I appreciate the conversation. I am.
Speaker 1 (16:36):
I just got a snotty text message from a snotty texter.
Can you give us a disclosure about how much you
were paid for this conversation? I will zero dollars. The
reason I'm talking about it is because I believe in it.
I believe that this is the way forward. I believe
that you can have a medical experience unlike the one
that my mother's having on Medicare, where she made a
(16:58):
list of issues to talk to her doctor about on
her annual checkup and her doctor literally said to her,
I can't talk to you about any of that, or
I have to charge you for a diagnostic appointment instead
of just a physical, and the physical was how do
you feel okay? Great, have a nice day. Legitimately, that's
what has happened to her. That's not enough.
Speaker 4 (17:19):
And that listener can go to dpcfrontier dot com and
they can see every direct primary care clinic across the country.
I'm not an only an advocate for US, I am
an advocate for this entire movement across the country because
it is the moral thing to do to change our
broken healthcare system.
Speaker 1 (17:37):
You can also find Pinnacle Advanced Primary Care on the website.
If you're in the process of shopping for insurance, I
would urge you to at least investigate direct primary care,
even if it's not Pinnacle. We got a couple of
people saying, are you coming to Littleton or Lakewood?
Speaker 2 (17:51):
Are you coming to Boulder yet?
Speaker 1 (17:52):
So I don't know what your expansion plans are right now,
but I know that there's people out there who want
better access. I would tell you that if you're in Littleton,
or it was Littleton they were asking about, it is
not a far drive to Skyrich Medical Center where.
Speaker 2 (18:08):
They have an office.
Speaker 1 (18:09):
How often are you actually driving to see your doctor,
and they do telehealth as well.
Speaker 2 (18:12):
I'm just saying I think.
Speaker 1 (18:13):
This is this is the answer for a lot of problems,
and that's why Travis is on the show because he's
knowledgeable and he loves direct primary care. Travis, I, does
your guest know of anything like this in the Atlanta,
Georgia area? What was the website again for direct primary
care that you could just put in where you are.
Speaker 3 (18:30):
It'll be DPC frontier dot org.
Speaker 1 (18:34):
DPC frontier as in Direct Primarycare Frontier dot org. You
can put in where you are and it will spit
out the direct primary care offices in your area.
Speaker 2 (18:46):
So there you go. There is no such thing as
an independent physician.
Speaker 1 (18:51):
They are all employees and directions rolled down from the top.
Speaker 2 (18:54):
Your guest is a unicorn.
Speaker 1 (18:55):
You guys, the physicians at Advance at Direct Primary Care
own the practice. They are beholden to no one and
that is why they remain independent and can do the
things that they are doing. Travis Bock Instead, great to
talk to you again and thank you for providing great
information for my listeners.
Speaker 3 (19:14):
Thank you, Mandy, appreciate you
One of my smartest guests making a return appearance. He's
(00:03):
the President and Chief Experience Officer of Pinnacle Advanced Primary Care,
a phenomenal direct primary care organization that is really helping
demonstrate how free market solutions can be the answer to
our healthcare situation.
Speaker 2 (00:18):
Travis, welcome back to the show.
Speaker 3 (00:20):
First of all, thank you, Mandy, so excited to be back.
Speaker 2 (00:23):
Well, we have a lot to talk about.
Speaker 1 (00:25):
And I always say I don't know anybody else who
knows more about healthcare and the delivery systems than you do,
because you consume this like water out of a fire hose.
And we're here today to talk about the fact we've
got a new administration, well new old administration coming.
Speaker 2 (00:45):
Back under the Trump administration.
Speaker 1 (00:47):
And in the first go round, Trump tried to repeal
Obamacare and failed again. The Republicans have failed multiple times
to repeal Obamacare. And I could argue pretty convincingly I
think that Obamacare has done nothing but drive up the
cost of healthcare in this country.
Speaker 2 (01:05):
Nobody is paying.
Speaker 1 (01:06):
Less unless they are on a subsidized plan than they
were before Obamacare. The care is not as good, the
premiums are more expensive, the out of pocket costs are ginormous,
but there's got to be a way to take what
you guys are doing and check market forces in And
I think that the Trump administration has indicated through Speaker
(01:28):
Mike Johnson, that they are looking to make some serious
changes to Obamacare, giving up the notion of repealing it.
But that means because Obamacare is like this giant umbrella
over all of our healthcare right now, that changes to
Obamacare will definitely have an impact on people and on market.
(01:49):
So what are your thoughts about where we are now
and what may or may not because no real policy
positions have been put forward, But what do you think
some of these changes might look like? How concerned should
people be about what's coming?
Speaker 4 (02:04):
So, first and foremost, Obamacare is It's a monster, right,
It is an onion that is never ending. And I
spent three days in Washington, DC in September on the
Hill pummeling politicians with questions about healthcare, and they all
seem to dodge it on both sides. And then you
talk to your friends and family about healthcare who are
(02:24):
really unhappy with it, but they dodge the questions that
don't want to change it. So what I think we
will see next year is that through the new administration,
there could be more choice, and it may require more
involvement from the healthcare consumer. At the end of the day,
if we want to change the healthcare system, we're going
(02:46):
to have to start looking at things in.
Speaker 3 (02:49):
Places and organizations that are doing it right.
Speaker 4 (02:51):
Anytime you talk about free market healthcare to people, I
get a glazed overlook because they have no idea what
that means. We can't dismantle the whole healthcare system overnight.
We need solutions, And when I was sending you text messages,
I'm like, Mandy, I'm not hearing about any solutions.
Speaker 2 (03:09):
Yeah.
Speaker 4 (03:10):
So what I would say to my Republican colleagues and
friends and conservatives is that we need to identify something
that's working. Direct primary care is a current healthcare movement
that is alive and rich here in Colorado, where family
physicians are saying good riddance to insurance and creating a
cash pay system for their patients and clients to do
a direct cash transaction with their family doctor. If you
(03:32):
have listeners who are sixty plus years old, they will
remember this.
Speaker 3 (03:36):
They will know what this is like.
Speaker 4 (03:38):
So we need to just start talking about actual solutions
that are happening.
Speaker 1 (03:43):
Well, you know, I, for a long time, and I
mean a long time, perhaps the entire twenty years that
I've been on the radio, have advocated for some system
that looks like this. We have two kinds of health care.
We have emergency health care, which is you have a
heart attack, they put you in the back of the ambulance,
you go to the hospital wherever they take you. And
that's one kind of healthcare. Injecting market forces into that
(04:06):
is challenging because it is a spur.
Speaker 2 (04:08):
Of the moment.
Speaker 1 (04:09):
You don't have time to call around, Hey, what does
a HEARTCAF cost at your hospital? That needs to be
dealt with with insurance. Right, that's where insurance comes into play.
You're basically insuring yourself against catastrophic losses for an emergency.
But all of the other things that I call this
scheduled healthcare, when I go in for a checkup, when
I go in to have my hip replaced, when I
(04:31):
go in anything that I am putting on the schedule myself.
There is no reason why we cannot inject market forces
into that part of the equation. And I think, and
I don't know, I'm pretty sure that a vast majority
of our health care is delivered in that fashion, right
it is people go into the doctor when they have
the flu, or they just need a check up, or
(04:52):
they need a sports physical for their kids. That is
the vast majority of healthcare is delivered in that way.
So that's what I've been advocating for. And that's one
of the reasons that I love direct primary care because
it is in a way free market choices. You go
and say, look, I don't want to pay an insane
premium with a ten thousand dollars deductible for my family
(05:14):
and not be able to get healthcare because if I
have to pay the first ten grand I don't have that.
Whereas with direct primary care, you sign up, you sign up,
you basically join the club. It's a membership program, and
then you're only paying wholesale pricing on the tests and
stuff like that. That if you go through your doctor,
they're going to not just charge you whlesale pricing in
(05:36):
that price is going to be the people that manage
the insurance, the pass through all of these other costs.
So it can be done. You guys are doing it.
What is going to have to happen in your view
or is there kind of a one view of how
to make that a nationwide proposition. Are people too married
to the concept of my insurance is going to pay
(05:57):
for it before they're willing to say, wait a minute,
if I did this, I would actually save money in
the long run.
Speaker 3 (06:04):
Yeah.
Speaker 4 (06:04):
We absolutely have an addiction to health insurance and we
are using it improperly. I was shopping around for tires
today for my car. I did not call Progressive and say, hey,
I want you to pay for my tires, because it
would go from a seven hundred dollars bill and all
of a sudden, my tires would cost ten grand. Right,
but tires are affordable because it's a free market where
(06:27):
you can go shopping. I think what scares the consumer
is we have not empowered them with any sort of
model that promotes the idea of shopping around. And for
some foremost working on preventive healthcare, we have created a
sick care system the United States that makes money off
of sick people. Right, because getting to your family doctor
(06:49):
is a six month ordeal. They're never going to get
you in, so you end up in the ear and
urgent care for your care.
Speaker 3 (06:55):
What we're saying is.
Speaker 4 (06:57):
Let's start with restoring primary care in family medicine. Let's
make sure everybody has access to a good family doctor
that they can reach when something is going on. Good
family health care can take care of ninety percent of
your everyday health and wellness needs. So we need to
start looking and saying, hey, let's fix this first. We're
(07:17):
looking at a shortage of fifty thousand primary care physicians
in the next decade if we do not fix something.
Seeing thirty to forty patients a day is not fun,
and doctors don't want to do that. In direct primary care,
they're seeing six to ten patients a day for about
forty minutes apiece.
Speaker 3 (07:36):
How do we do that.
Speaker 4 (07:38):
We have changed the financing model for our practice. No insurance,
no government kickbacks, no subsidies, none of it. If we
did those things, it would cost forty percent more to
go to our practice.
Speaker 1 (07:51):
Holy crap, it's that much. Just the bureaucracy it costs
forty percent more.
Speaker 3 (07:58):
So imagine this. Sixty nine thousand ICD ten codes. People
think that.
Speaker 2 (08:04):
Your health What is an ICD ten code? What is that?
Speaker 4 (08:07):
So you talk about your elbow, there's a code for that.
You talk, you have a complaint about your in laws.
There's actually a code for that.
Speaker 2 (08:15):
Shut up.
Speaker 4 (08:17):
No, not at all, because your medical record, yes it's
a medical record, but it is a billing document at
the end of the day. Our practice accepted insurance, forty
percent of our revenue would.
Speaker 3 (08:30):
Go to sending you a bill at the end of
the day.
Speaker 4 (08:32):
So if we cut that mess out and say, hey, Mandy,
if you just want to take cash to your doctor,
it's kind of like cost go for healthcare, right, you
have a membership and you're getting everything out.
Speaker 3 (08:43):
A wholesale cost.
Speaker 4 (08:44):
We dropped a lab cost for a woman from eight
hundred dollars same local lab. We negotiated cash paid to
the same lab for forty nine bucks.
Speaker 2 (08:53):
Oh my god.
Speaker 1 (08:54):
That is that is just I mean, that's I think
part of the problem, Travis, is that the medical services,
and traditionally are medical services, the pricing is completely opaque, like.
Speaker 3 (09:07):
We have no idea.
Speaker 1 (09:08):
You go to the when I was told and I've
told this story before, and I think I've told it
to you before. When I went in ten years ago,
before I did regenerative medicine on my knee, and an
orthopedis said, well, you need to get an MRI, and
I just out of curiosity, said, well, how much does
an MRI cost? And he said to me, well, it
depends on your insurance. I go, but what does it cost?
(09:28):
And he had no idea, no clue whatsoever. And he's
the physician saying I need to have this, but even
he had absolutely no idea.
Speaker 2 (09:38):
How much it cost.
Speaker 1 (09:39):
And I thought to myself, that's a huge part of
the issue, right, is that everything is so opaque. We
don't know how much things cost. And even if you can,
I don't know if you've gone to the hospital listing
of pricing, it's absurd. It is so dense and hard
to read. If you do not know, if you're not
a medical biller, you have no idea what's in those
(10:00):
They've made it, I think on purpose. They've made it
horribly challenging to figure out how much something is going
to cost so you can make a decision about whether
or not to have that test or procedure. And a
lot of times those tests or procedures are only ordered
as a cya for the doctor for legal purposes. And
I don't blame them. This is the game they have
(10:22):
to play. But there's so much waste in the medical system.
Speaker 3 (10:26):
There is a vast majority of it. It's actually waste.
Speaker 4 (10:29):
And I don't want to use this position's name to
protect their privacy, but I had a conversation with them
and said, what was your tipping point in getting out
of this mess and going into a direct primary care practice?
Speaker 3 (10:39):
And they said, you know what.
Speaker 4 (10:40):
Travis was working in rural medicine and a hospital CEO
sat us all down and said, I need you to
order more MRIs and he goes why, And I'm paraphraming this,
paraphrasing this, but it was basically like, if you want
a paycheck, you will order more MRIs and it's not medically.
Speaker 3 (10:58):
Necessary to do.
Speaker 4 (11:00):
If any of you have ended up in the er unfortunately,
or urgent care you have so much blood taking out
of you, they do all the scans possible because it's
bill bill bill right, And unfortunately, we have a bloated
system that relies on one person paying ten thousand for
their replacement and the other person paying one hundred. It
(11:20):
would be insane if we pulled up to a McDonald's,
got a burger, got to the window and they said,
a Mandy.
Speaker 3 (11:26):
No bill for you today, and you're like.
Speaker 4 (11:28):
Really, and they're like, yeah, based on your insurance or
your food company, whatever, we'll send you the bill later.
And your McDonald's cheeseburger is now ten thousand dollars, but
the guy behind you paid by right.
Speaker 3 (11:39):
That is insanity.
Speaker 4 (11:40):
We would never allow that in any other system, but
we allow it in the most personal buying decision we make,
and that is healthcare.
Speaker 1 (11:47):
So there's a couple of things that I would like
to see, and one of them may come true sooner
rather than later, and that is Biden expanded the Obamacare
subsidies and they expanded them to four times the poverty level.
And there's a lot of people who are taking advantage
of that, meaning they are taking taxpayer dollars to subsidize
their health insurance premiums. Now, I don't want people to
(12:09):
be without health insurance, but the more people that we
take out of the pain point, the less people there
are to advocate for a significant change to the system.
But Travis, I think we are seeing now the government
is reacting because now the government has made an edict
that if you are a Medicare, if you are a
doctor who accepts Medicare, and all of a sudden, you're
(12:31):
not taking that anymore, as someone on Medicare can no
longer cash pay for physicians or there. I mean, think
about that for a second. Somebody says, look, I just
want to I want to cash pay for this.
Speaker 2 (12:42):
I'm going to pay for it out of my own pocket.
Speaker 1 (12:44):
The government has said no, you are not allowed to
accept cash payments from patients who want to work outside
the system. That to me says they know the system
is jacked up, but they have to keep us all
in it in order to keep it moving forward and
make sure that everybody's pockets are getting lined.
Speaker 3 (13:00):
No, that's absolutely true.
Speaker 4 (13:01):
There's a few bills out right now that would expand
direct primary care to veterans.
Speaker 2 (13:06):
Oh wow, that would be fantastic.
Speaker 3 (13:07):
It would be huge because we know they have access issues.
Speaker 4 (13:10):
And if forty minutes to an hour to spend with
a veteran, think about how many things you could talk through.
Then we've got the medicaid situation you were talking about.
Speaker 3 (13:19):
In the state of Colorado.
Speaker 4 (13:21):
Cannot electively choose to go to our practice or we
could get in trouble, and so could the Medicaid recipient.
I'm not asking for Medicaid dollars. I'm asking for that
Medicaid recipient to have a choice in their care, and
then hsas why can you not use your HSA monies
to pay for a direct primary care membership can do that. So, yes,
(13:43):
the system is rigged in a way that does not
allow innovation to happen. But this is precisely what we
need to start to fix our healthcare system.
Speaker 1 (13:53):
What I think is a very interesting proposal. I can't
wait to see if RFK Junior ends up as the
secretary or some role at Health and Human Services because
there are things that he wants to do, specifically taking
drug ads off television that I think would be a
game changer for just medicine overall, because so many doctors
(14:16):
are having patients come in and say, oh, I want
to try this medication.
Speaker 2 (14:19):
It's the newest, most expensive.
Speaker 1 (14:21):
There are so many ways that our system is distorted,
absolutely distorted, Travis, I got to share some of these
because now there's a couple of them that have come in,
specifically about Pinnacle.
Speaker 2 (14:32):
I love Pinnacle.
Speaker 1 (14:32):
Doctor Dygert actually spends time with you and you don't
feel like you're being pushed out the door.
Speaker 2 (14:37):
Through Pinnacle.
Speaker 1 (14:38):
My echo cardiogram costs less than two hundred bucks. I
was quoted over five thousand from a normal provider. It's working,
it's happening. I don't know what else we can do
to support freedom in healthcare decisions, but we've got to
allow people to opt out of a system that is
geared to your point to run up billing. I got
(15:02):
to tell you, I think the main reason that the
medical community has endorsed the medicalization of children who are
gender dysphoric is because one of those patients is worth
well over several million dollars over their lifetime as a
medical patient. That is horrifying, but there's been too many
(15:23):
medical professionals who have said some variation of that for
me to ignore it. We have to take that incentive
out of medicine and just help people understand what there
is that's different or new or or options that they
have to make a different choice. And that's really what
(15:44):
it's all about, like let us choose.
Speaker 2 (15:46):
Our own stuff.
Speaker 4 (15:47):
Let us choose our own stuff and take a step back.
I want your listeners to take a step back and
go every single thing we have the government do for
us for our healthcare.
Speaker 3 (15:56):
They can take away.
Speaker 4 (15:58):
Correct administration anytime, can change it up. I'm asking people
to own your primary care experience.
Speaker 3 (16:06):
Put your money where your mouth is.
Speaker 4 (16:08):
Support a local physician in your community. We have ninety
of them across the state of Colorado, ninety independent physicians
doing this.
Speaker 3 (16:17):
Put your money where your mouth is. I don't care
if you have the Platinum insurance.
Speaker 4 (16:20):
Plan, invest in a local solution, keep your Platinum plan.
Speaker 3 (16:24):
I don't care.
Speaker 4 (16:25):
We just know that next year it might change and
your doctor may go out of network. But you own
your Pinnacle membership as long as you pay it well.
Speaker 2 (16:34):
Travis, I appreciate the conversation. I am.
Speaker 1 (16:36):
I just got a snotty text message from a snotty texter.
Can you give us a disclosure about how much you
were paid for this conversation? I will zero dollars. The
reason I'm talking about it is because I believe in it.
I believe that this is the way forward. I believe
that you can have a medical experience unlike the one
that my mother's having on Medicare, where she made a
(16:58):
list of issues to talk to her doctor about on
her annual checkup and her doctor literally said to her,
I can't talk to you about any of that, or
I have to charge you for a diagnostic appointment instead
of just a physical, and the physical was how do
you feel okay? Great, have a nice day. Legitimately, that's
what has happened to her. That's not enough.
Speaker 4 (17:19):
And that listener can go to dpcfrontier dot com and
they can see every direct primary care clinic across the country.
I'm not an only an advocate for US, I am
an advocate for this entire movement across the country because
it is the moral thing to do to change our
broken healthcare system.
Speaker 1 (17:37):
You can also find Pinnacle Advanced Primary Care on the website.
If you're in the process of shopping for insurance, I
would urge you to at least investigate direct primary care,
even if it's not Pinnacle. We got a couple of
people saying, are you coming to Littleton or Lakewood?
Speaker 2 (17:51):
Are you coming to Boulder yet?
Speaker 1 (17:52):
So I don't know what your expansion plans are right now,
but I know that there's people out there who want
better access. I would tell you that if you're in Littleton,
or it was Littleton they were asking about, it is
not a far drive to Skyrich Medical Center where.
Speaker 2 (18:08):
They have an office.
Speaker 1 (18:09):
How often are you actually driving to see your doctor,
and they do telehealth as well.
Speaker 2 (18:12):
I'm just saying I think.
Speaker 1 (18:13):
This is this is the answer for a lot of problems,
and that's why Travis is on the show because he's
knowledgeable and he loves direct primary care. Travis, I, does
your guest know of anything like this in the Atlanta,
Georgia area? What was the website again for direct primary
care that you could just put in where you are.
Speaker 3 (18:30):
It'll be DPC frontier dot org.
Speaker 1 (18:34):
DPC frontier as in Direct Primarycare Frontier dot org. You
can put in where you are and it will spit
out the direct primary care offices in your area.
Speaker 2 (18:46):
So there you go. There is no such thing as
an independent physician.
Speaker 1 (18:51):
They are all employees and directions rolled down from the top.
Speaker 2 (18:54):
Your guest is a unicorn.
Speaker 1 (18:55):
You guys, the physicians at Advance at Direct Primary Care
own the practice. They are beholden to no one and
that is why they remain independent and can do the
things that they are doing. Travis Bock Instead, great to
talk to you again and thank you for providing great
information for my listeners.
Speaker 3 (19:14):
Thank you, Mandy, appreciate you
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