Concierge medicine was in the news again today. Concierge medicine is not yet a widespread phenomenon, but has been increasing in popularity as primary care doctors find it increasingly difficult to provide attentive care to their patients, and maintain a worthwhile lifestyle at the same time. For those unfamiliar with the concept of concierge medicine, it works as follows: doctors charge each patient an annual retainer. The fees vary, but $1000-3500/yr appears to be a commonly quoted range. In return for this, the patient receives 24/7/365 access to the practice via email, cell phone, etc. They receive on-time appointments without delay, and appointments are not the typical 10 minute one so common to rushed primary-care practices today.
Not surprisingly, concierge medicine has generated debate as to whether this system is ‘fair’ for patients who are unable to afford the retainers. Also, it must be pointed out that concierge medicine is not insurance. That is, patients will still be responsible for other healthcare services such as hospitalizations, surgery, diagnostic imaging, etc. Concerige patients need to maintain their regular health insurance in order to be properly covered.
One line of attack against concierge medicine is that it is acting as a form of insurance, and concierge practices are in effect operating as an unlicensed insurance company. It is still too early to be sure how this will play out, but these arguments miss the overall point that the concierge medicine trend illustrates.
Is healthcare a fundamental right? Or is it a service provided by professionals with fees set by market forces? If it is the former, than a national health system, or a private system with a foolproof ‘safety net’ for those unable to afford private care, makes sense. If it is the latter, than concierge medicine reflects an effort by private-sector primary care to provide this service in a fashion that makes more sense than the current system does.
The system has not determined what the answer to this question is, although it is clear that the administration as well as many prominent politicians, such as the late Sen. Kennedy, believe that it is a right. For now, individual providers are deciding for themselves, and adjusting their own terms of participation in the system.