by Chad Savage, M.D. – Nov 09, 2019 – Originally published in

The most terrifying words in the English language are ‘I’m from the government and I’m here to help.’” Ronald Reagan uttered these words more than three decades ago, but they still ring true today. Like Reagan, 1,500 physicians are concerned about the perils of government intervention that means well but fares poorly. That’s why they have signed a petition imploring the American Academy of Family Physicians (AAFP) to oppose the bill HR 3708, which is purportedly designed to help them.

Despite the House resolution’s upbeat title and good intent, the Primary Care Enhancement Act of 2019 would hamstring the most innovative category of primary care physicians in the country — harming doctors and their patients.

Most of the doctors who have signed in opposition to HR 3708 practice under a patient-friendly model called direct primary care (DPC). These doctors practice outside of the insurance-based payment model. Instead, DPC physicians offer comprehensive primary care for an extremely low monthly fee — and offer huge discounts on more specialized care.

Liberated from the time-consuming and costly insurance industry, DPC physicians can devote more time to their patients — providing better care and cheaper prices on services, labs, imaging and medications. And if the IRS clarifies the ability to use Health Savings Accounts (HSAs) for DPC, everything could become even more affordable. HSAs use pre-tax dollars to pay for qualified medical expenses. Counting DPC monthly fees as HSA-eligible expenses would result in huge savings for patients.

HR 3708 claims to ensure the IRS classifies DPC correctly — i.e., to write into law that HSAs can pay for DPC. So, why do more than 1,000 doctors who would seem to benefit from this bill oppose it?

Because it would shut out specialists, cripple innovation, and limit patients’ treatment options.

As written, HR 3708 would restrict specialists, such as cardiologists, from engaging in DPC’s innovative and streamlined monthly contribution model. It would take years for specialists to fight back and push for new legislation to correct this mistake, all while patients pay more for treatments they desperately need.

Originally published in