READERS SUMMARY:
1. Are you interested in an ancestral/primal/paleo insurance company?
2. Would you like to help gives us input in what you want and what you would like to see in this plan?
3. Where do I leave my comments on this topic for the 2012 AHS?
4. Can other primal/paleo/ancestral bloggers, followers, enthusiasts make this go viral to benefit all of us?
5. Why do we want to do this for our community?
Many of you know that out of the AHS of 2011 many good thing occurred. The meeting really galvanized the community and now it is time to think about how to make this community leverage its power. Turn the kinetic energy of what was 2011 AHS to the potential energy of 2012. This was really brought home by Brent Pottenger recent post that I hope you all read. Please read the link to his post for you to read. Brent was one of the founders of the genesis of what eventually became AHS 2011. He told me recently that he had no idea where his 2009 idea would end up. Well, we just saw the effect of 2011 AHS in our community with all the posts about it. Now Brent and I are proposing an even bigger idea. We want to change healthcare delivery for our community. Our goal in this community to create for patients another avenue in the healthcare system for you to have access to physicians and healthcare providers who support this lifestyle and understand that the needs and services are quite different many other patients. Our goal is to create just a system for you. Eventually, this model may become something that can be generalized to the general population once the deep science behind this movement is made mainstream. This will be a massive undertaking but before action comes upon it we need to really think well about how to do it. Brent and I have already spoken by phone and we plan to reconnect often the next few months going forward to develop some ideas we have. We both thought it would be a great idea to open this process to the people who obviously will benefit the most from this…you, the patient or customers of these services. We want to hear loud and clear some of the things you would like incorporated and some of the new ideas you may have no matter how out of the box it is. Please leave them in the comment section at the end of the blog. If you’re a friend of ours on Facebook, leave them for us there or you can tweet them to us as well. If you don’t feel comfortable doing that you can email it to me at [email protected] or send them to Brent at his site, www.epistemocrat.blogspot.com. We need to hear what you would like in this type of plan.
The system we envision will use a lot of new internet technology and will require the doctor patient relationship to change in some ways on both your side and our side. We think, however, you will have more access to your doctor and you will also have cutting edge data available to you faster than you would in a conventional system. Rest assured the conventional system will still be a part of this plan. But we want to use our system as a Trojan Horse to infect the conventional system to instigate changes. We also want to form our own ACO and we are also looking into the possibility or starting up our own self insured insurance company dedicated to members who practice our style of living.
Our goal is to collect all ideas over next 6-8 months so we can have a full presentation to offer the entire community for review at next years AHS 2012. Please help us, help you, in making a difference for your future healthcare and wellness care. As Brent said in his note, we are at a tipping point of a revolution in healthcare. If we stay quiet and passive, we will have no control in dictating how we all want to be treated when we are sick or when we are well. Many of us will just need advice on how to optimize our situation as we age.
Thanks for reading this and please make it viral to all you friends and family on FB, twitter, or on your own blogs. We think this is an important next step in the process for this movement. If you believe this too please participate. We want to build this the correct way by asking for input from everyone. Thanks for reading and we are looking forward to your inputs and comments. I am planning on keeping this blog post up for sometime to get the ball rolling but I am hoping that our community uses technology to get this message out!
This is something I have been actively researching for the past few months. I have a few ideas and would like some feedback from an active member of the medical community.
First and foremost give me unrestricted access to all my medical records electronically. I just had my doctor snail mail me some results and I had asked him to email them to me. He said he couldn't do that. I don't know if it was due to HIPAA or what but I know the hardware is there to get this done.
Take the time and effort to compile a complete patient history. Not only from the patient but from any and all past medical records. Creat one unified medical file.
Have at least an annual physical with the proper bloodwork done and then make reccomendations on that bloodwork. With patients that are just strating down the path to good health put them on a proper testing schedule to be able to track the direction of their progress.
Make sure any and all docs have a cap on the number of patients they can accept. Make sure each doctor can spend a minimum of 1-2 hrs with each patient at each of their check ups, meetings, etc. The biggest thing is time and interest in the patient. Kick any doctor out that has low patient satisfaction scores. I think a huge problem in the healthcare industry is that patients think that doctors don't care about them.
This is just a broad strok of the direction that healthcare needs to take in order to get away from the pay for service model. It isn't going to be easy and most healthcare systems aren't going to move this direction until it is too late. CMMs isn't helping matters either.
Dr K – sent you an email – as my reply grew to long for this. Thanks so much for Optimizing my Health – with you knowledge. I wish all doctors took the time to do this…
+1 to Chris Tamme, As a prior military member I had required yearly checkups fpr 20 years; I have continued that since and still get them with my current job for blood and heart checks as a minimum. I have all my data transfered to my Capsule PHR app on my iPad, wish there was something better for the lay folk.
So for me the biggest improvment would be for digitally available data! Emails or data files given to patient.
Hope to add more as I mull the concepts over.
Thanks!!
Don't forget to plumb the depths of paleohacks.com:
http://paleohacks.com/questions/1350/private-insu…
Insurance should be, well, insurance, in that we contract for it for accidents and unforeseen events. The healthcare part of it should be separate, and include stuff like the sort of blood tests we should take to make sure everything is working like we think it is. Let me note that there are likely blood tests that could measure our compliance with whatever the company decides is 'paleo'- I am not sure how I feel about that, but I realize that a metric for compliance would probably lead to more savings on the insurance side since higher compliance would likely lead to fewer degenerative diseases later on.
Initially you might consider setting something up along the lines of concierge Physicians .
"Concierge physicians care for fewer patients than in a conventional practice, ranging from 100 patients per doctor to 1,000, instead of the 3,000 to 4,000 that the average physician now sees every year.[3] All generally claim to be accessible via cell phone or email at any time of day or night or offer some other "special" service above and beyond the "normal" care provided. The annual fees vary widely, from $600 to $5,000 per year for an individual, with the lower annual fees being in addition to the usual fees for each service and the higher annual fees including most services."
http://en.wikipedia.org/wiki/Concierge_medicine
Unfortunately concierge physicians are for the " haves" not " have nots". The big issue I see is how to get around the grip of employer supplied health care insurance. A lot of functional medicine docs and hormone replacement are working outside of the conventional insurance system, with many of their fees and services treated as " off plan. ". Once again, only for those who can afford them. We already gave start of a two tiered system.
I like the Trojan Horse idea.
This is a GREAT idea! Go for it. I will spread the word via facebook, Forums etc.
I'm in !! any change to the way things are currently done will be much welcomed. I know when I ask my current Doctor to runcertain blood tests to see where I am in my changes of diet(paleo)he always questions me and then says my insurance won't cover these tests, sends me over the top!Need to find a paleo doctor near me, anyone know of one in central Connecticut?
Actually there are concierge-lite offices that are available for under half the normal charges for true concierge practices. I have this set up in my practice and have been attracting quite a few paleo, lowcarb patients this year. So this concept may just work if it can be presented well.
We need more docs…..are you a paleo doc or an interested paleo bystander? Dr. Kruse
It is so fantastic to see this all coming together. I want to hear Dr. Rosedale as a featured speaker next year as he is after all the one who put on the map leptin and it's metabolic effects back many years ago when everyone else was still not understanding the negative effects of high protein, amazing understanding of mTor. I heard him talk in Russia and also in Frankfurt and he would have blown everyone away had he been at the 2011 conference.
Bring it to the East Coast.
I love the idea of a concierge paleo practice! If there was one where I live (Seattle) and it wasn't at the top end of spendy I would take advantage of it along with my high-deductible health care plan.
Start advertising/marketing/getting the word out to the general public about the Paleo Phsycians Network. Perhaps change the name to something like "Allied Paleo Healthcare Network," as there are more healthcare providers on it than just physicians.
This is an awesome idea! We don't need as much medical attention so our risk ratings should be much lower. I'm on board, we just need more Drs in Atlanta!
Pat, have you seen this? http://paleophysiciansnetwork.com/
I think it would help to identify the problems of the current system for others to present solutions. Right now, I see a naturophatic doc instead of medical doc. I find NDs much more open to dietary/lifestyle changes than MDs. As of now, I have no need to see an MD because my ND provides everything I need. I'm also well educated about how to treat my IBD and make my own health decisions often.
I like the idea of buying coverage directly from the doc. I've heard of these as Community Supported Healthcare, like this one from Dr. Cowan in SF. An MD, but one that uses a lot of "alternative" approaches. http://fourfoldhealing.com/csh-faq/
The one major change in the entire healthcare industry that I'd like to see changed is a financial model to reward doctors who actually see the patients health improve, not merely on the treatment of disease.
This is a fantastic idea! I've been mulling it over and wonder if it could be modeled similar to auto insurance where you get "good driver" discounts that make your premium lower over time? For example, if I stay free of the standard chronic diseases AND I use my MD services minimally like 2-3Xs per year to get my blood panels looked at, (and maybe some other criteria met), could I get "points" that lower my premium despite my age?
I hope Obamacare doesn't ruin this plan. I heard that in 2014 we will ALL have to purchase health insurance, and insurance companies won't be able to sell catastrophic health plans to those over 30.
We need lots more docs. Atlanta, with 5 million people has 4 paleo docs and a handful of "functional docs". None of the paleo ones do primary care.
Somehow the message needs to get out to docs, probably BEFORE they start medical school, and THEN they need training and some sort of certification and standards. Start by forming a lose network, setting up mechanisms for phone consults, figure out a way to " infect" the mainstream docs by dazzling them with success. If patients start showing up at their PCP annual physicals having lost weight, controlled blood sugars, dropped cholesterol numbers and LOOKING GOOD NAKED it will start to get their attention. They can't be oblivious to the act that more than half of the staff in theirs offices is obese. You wouldn't go to a dentist whose staff all have gnarly teeth, or to a hairdresser with ugly hair, would you? It's going to take patients and docs like you guys to do the Johnny Paeoseed bit.
Jack, any insurance plan will fail unless, we, the patients, first learn to take personal responsibility for our health. An insurance should be for unforeseen events, like sudden onset of a degenerative disease or need for surgery or an unfortunate accident. I am on board with your idea, but would like to know how you will address the personal responsibility issue.
Thanks, Dr. Kruse.
I look forward to reading all the feedback and ideas that we receive; crowd-sourcing what patients would like to see is key!
I'm presuming that the cost of group insurance would be reduced in a population who actively takes care of their health. Lower rates would certainly appeal to me. The insurance coverage should be committed to a preventative health model—charging little or nothing for preventative exams, tests, birth control, etc. Perhaps charges for chronic, generally preventable medical treatments (i.e monthly insulin for obese type II diabetes patients) would be higher than the average insurance charges so that imposters would leave voluntarily. Sadly, there's little monetary incentive in common health insurance plans to avoid medical costs by living a healthy lifestyle. My family of three is currently covered by husband's company group insurance policy. We relatively rarely incur medical expenses but must pay expensive monthly rates equivalent to majority of subscribers who don't bother investing in their health (eat the cheapest junk food, don't spend time doing significant physical activity, figure all their health problems should be solved by a pill or technology, don't bother getting outdoors, etc). Good drivers get auto insurance discounts. People who daily make extra effort on healthy choices also deserve a discount. The lower insurance rates could offset the higher costs of food (i.e. more expensive oils, pastured meats, organic vegetables, and loss of cheap grain filler foods that the uninitiated moan over).
In a scenario where my thrifty husband didn't quite meet the criteria (perhaps with newly revealed borderline levels of inflammatory markers), I'm betting he would finally be motivated to live a bit more primal (like myself and my daughter) by the prospect of lower insurance premiums. On another personal note, I hope the doctors would take a holistic approach with broad inquiry into sleep, stress, psychological, environmental issues—not just diet and exercise. I know quite a few WAPF adherents who are focused almost solely on food without attention to more sleep, fitness, & play that could probably rejuvenate them (not to disparage WAPF; I just don't know any paleo people where I live for comparison).
I would like to see paleo network doctors arming patients with sound scientifically-based advice and encouraging individuals to take responsibility for their health. The insurer should ban pharmaceutical and medical device sales reps from soliciting the preferred providers. I would gladly submit blood samples (i.e. for AGEs levels) and BMI measurement to provide evidence of my actual compliance with a primal/paleo lifestyle before being allowed entry. Perhaps people who are new to the lifestyle could be allowed a short trial period (months) to get their measurements within compliance before suffering a rate hike or exclusion if the entrance criteria still haven't been met. Maybe old people would have slightly looser criteria than the young. It seems trickiest to decide how to assess non-compliance before kicking people out of the insurance plan.
I would LOVE to see a demonstration of how upfront investment in preventative evolutionary heath measures lowers long-term health care costs and I would love to participate.
I disagree with Resurgent – this Paleo plan should emphasize prevention, not just the unforeseen events – that's what conventional insurance already does. I don't think a doc needs to spend 1 to 2 hours every visit, but they do need to spend time beforehand figuring out blood work results and a treatment plan, so it's not all done on the fly with the patient sitting there.
A big question will be what will qualify someone for this insurance?
@ Owl…..disagree all you want…but leave ideas. We need Resurg and your ideas at this point whether they agree or not. The more we get the merrier.
@Pat Palmese & everybody else in here: Jimmy Moore has a link on his site to a list of what he calls Low Carb doctors from around the country, and the list continues to grow as he discovers them or as people recommend them. Not paleo doctors by definition but close enough, at least they understand & treat their patients according to their understanding of the low carb lifestyle, here's the link. http://lowcarbdoctors.blogspot.com/
This is larger than low carb docs of which I am one. We need to create a system that can help people who live this way access care that is based upon evolutionary biology. That is a far bigger task that we are undertaking. Just keep the ideas coming. Share this with as many people as you can. The more brains that see it the more ideas that will come to build a better platform than we have now.
Phone/webchat appointments would be awesome. A pre-call to get labs and such and then a follow up video chat appointment would be amazing. Simply because there aren't enough paleo docs around and the knowledge is just not there in conventional medicine. It's hard enough to be a strong patient advocate, but when you are trying to educate your doc too, it's too overwhelming.
I think there are three key elements to an Ancestral Health Insurance program.
1) There needs to be a network of health care providers who can work with patients on ancestral lifestyle changes. Just like existing insurance programs you would have a primary care physician with in-network and out-of-network reimbursement for specialists.
2) The insured must pay a portion of their health care cost. They must be connected to the costs of delivering health care.
3) There must be a way of rewarding good behavior and punishing bad behavior to ensure (insure) compliance. It's done with car insurance why not health insurance? Annual testing and lifestyle questionnaires could be used determine premium costs. It would also assist the doctor in helping the insured make the appropriate lifestyle changes.
There are no new ideas here. The main idea is to create a low risk pool to keep health costs low.
Structurally, the insurance company would be a membership associatio like the California State Automobile Association or a credit union. Any profit would go back to reducing member premiums.
http://www.voiceforhope.net/2011/08/17/ancestral-…
http://primaldocs.com/
&
http://paleophysiciansnetwork.com/
Thanks Brent!
Guess I don't have much to add that hasn't already been said! It would be nice not to have to pay out the wazoo for a VAP, maybe lower premiums for those who carry gym memberships (I don't know what incentive could be given to the many paleo folk who work out at home and outdoors, but it's a start). Definitely would want to see coverage for "alternative" stuff- acupuncture, naturopaths & whatnot.
Isn't Robb Wolf already doing this?
http://paleophysiciansnetwork.com/
Dave……Robb is but we are planning something a bit different. And I think the more people who do this the better the final product. I am sure we will all attack this differently but we are in the idea collection phase now to garner what people want and assess what we can do. With this info we will put forth a plan at next years AHS 2012 for you all to critique and ponder.
http://lowcarbdoctors.blogspot.com/
The ones listed in my large city are all OB/GYN who also to do bariatric medicine. Not what I was looking for. I think many people would do well with a good integrative medicine doctor who was not a vegetarian.
Don we are aiming to have a full scope of docs to handle issues.
I'd be happy to just see doctors list the prices of various types of service for those of us who must pay out of pocket, to start with. A few clinics here in Florida do this, but I'd like to see that more wide spread. Even with a lot of on-line labs, they give prices for blocks of tests, but very few will present the price per each individual lab test if I want to just get a few specific tests at a time. I realize many things can be tested at the same time, but since I'm not aware of what all CAN be seen in one test, I guess I just want to have some specific tests and their prices listed so I can discuss what I need with a doctor and have them tell me what else they can learn with that same blood draw. I may never be able to afford both insurance and the actual health CARE and diet and/or supplements that I need. If the prices are listed (in general) for each service or consult, then I can choose where to spend my limited funds.
http://vimeo.com/27962851
This doesnt have to with direct patient care but I think we need a foundation to fund and/or perform the research that currently isn't being done. We need to bypass the current research that is all being funded by big pharma and big ag.
Very good idea.
having a physicians phone list is not enough. who knows how good these doctors are?
http://exuberantanimal.com/web/library/essay_stor…
From a researcher's pov: Compliance is not necessarily a concern in terms of measuring diet/exercise, as people are notoriously bad about it anyway. Researchers tend to let biomarkers do the talking, in this case, HgbA1c, insulin, CRP, BP, BMI, and others. In an ideal world, we would have access to our own medical data, but a standardized data collection form–with MD signature–would be appropriate for research. It could be scanned/faxed to data collection site. I would think newcomers should be welcome if we want to find improvement in these biomarkers over time. Finally, you don't necessarily need a paleo/WAPF/low-carb MD to do this, just an MD willing to go along–the paleo insurance plan may be a more powerful tool than trying to recruit MDs. Any MD can order labs; insurance companies pay for them.