Health care for the rich

Dear Editor:

It seems that you have failed to digest the difference between what we in Washington call "access-fee practices" and "retainer-fee practices." (Risk & Insurance, March 2005, page 20.) Access-fee practices charge for special access rights for patients who wish for services beyond what their insurance would guarantee by their contract. But every service covered on the insurance is still charged to the patients' insurance plan or they pay out of pocket per service.

Since the parent clinic group has other insurance-based practices which do not charge an access fee or provide these special services, it is true that the patients are stratified by their ability or willingness to pay the extra fees. (Oh, surprise! The patients driving a Lexus want to be able to buy more personalized health care than those driving a Volkswagen.)

Our practice, on the other hand, has been designated by the Washington State OIC as a "retainer practice" because we charge on/y the monthly fee. Our fee is lower than the "access fee" charged by similar programs. Our patients pay by age group, from $35 a month for kids to $75 a month for seniors, and it covers their access and their care. We have no contracts with insurance companies, although many of our patients have insurance, Medicare, even welfare, and choose to pay our modest fee out of pocket for our services.

Now I think you have to admit that our fees are hardly high enough to be accused of catering only to the rich!

In fact, we find that it appeals to many who cannot begin to afford insurance on their own. If they choose to pay each month a flat fee which is less than they are spending on lattes, and happen to get quality personalized care that they could not afford to pay cash for at a traditional practice, we feel we are accomplishing our mission.

NANCY J. MORGAN

Medical Doctor

Mill Creek, Wash.

COPYRIGHT 2005 Axon Group
COPYRIGHT 2005 Gale Group