A family-practice doctor from Idaho Falls, Dr. Jim Brook, told the Legislature’s interim committee on the state’s health coverage gap that he’s closed the gap in his own practice – by following a unique business model, in which he doesn’t take any insurance, collects directly from patients, and has low rates. “I don’t take insurance, Medicaid or Medicare payments,” he said. “Patients pay me directly, which means that I do not need a group of clerks to try to collect my fees. My overhead is about a quarter of the overhead of a typical family practice doctor.” He said that’s why he can afford to have lower rates. “Last year my collection rate was 101 percent – that’s because of tips that the gap population paid me,” he said. “My average fee in 2015 was $58,” including medications and labs.
Brook said he’d like to see his model spread, including to surgery centers and imaging centers. “Patients would come from surrounding states,” he said. “Idaho could become a medical tourist destination.”
Under questioning from committee members, Brook said he requires patients to pay at the end of their visit, and tells them so up-front. If they say they have no money, he tells them to talk to friends or family to come up with it. Because his rates are low, people can afford them, he said; he charges based on the time he spends. He said he sees 12 to 14 patients a day, and has been operating his practice on this model for about 13 years. Brook also told lawmakers who asked about catastrophic and emergency health issues that he recommends that his patients get catastrophic health insurance coverage to cover such things as car accidents and cancer.
Brook, who was accompanied at the meeting by Fred Birnbaum, vice president of the Idaho Freedom Foundation, said he believes that “government interference” is what has driven up the nation’s medical costs. He said he hasn't bought health insurance for himself or his family, choosing instead to "access care through the free market."