Today, my daughter, my parents and I drove to the hospital in Boulder to see the latest member of our clan. My brother and his wife just had their first child and it was time to go a visiting. On the way back, my Mom talked about Presidential Candidate Carson’s idea for health care savings accounts. What was interesting was why the idea appealed to her. When she was growing up, most people didn’t have health insurance. You just paid out of pocket. If you can pay for health care out of pocket, then a savings account is a great way to be prepared.
My Dad remembers leaving school and walking to his grandfather’s house where he read to my Dad. His grandfather could do this because he was a Veterinarian. Veterinarians, and Doctors, often worked for themselves out of their homes. Doctors could even make housecalls because they knew everything they needed to know and could carry most of their equipment in a bag.
But, medicine no longer looks like that. One generalist with a handful of tools has exploded into miles of specialities and catalogs upon catalogs of medicines and equipment. That explosion has increased life spans but part of the price is equipment and medicine that costs more than most people could ever pay for out of pocket and sometimes more than the specialist’s price new sports car.
Doctors don’t make house calls any more because that entire model of medicine is dead. We replaced it with a model that provides the capital to purchase the equipment, hire the list of specialists and build the buildings to house it all. We replaced craftsman with businesses: we corporatized medicine.
Recently, cash-only medical practices have launched. If everyone in the U.S. switched to cash-only practices and paid for health care out of pocket, they would each pay an average of $10,000 per year. Ye average sized family would spend $40,000 every year on medical care. A lot of Americans would need raises; big big raises.
One way to answer “Why don’t doctors make house calls any more?” is to say “Because you probably can’t afford the three that do.”