I realized the system was broken,
so much to the point that 
I was part of the problem
of contributing to that broken system.
- Dr. Timothy Wong doesn't take 
any insurance in his practice -
and charges most of his patients 
$35 for a consultation.
We would always have to fight
the insurance companies
getting something a patient required.
We're talking about 
having to do extra work 
just to get a diabetic 
the insulin they need;
having to get a patient a 
life-sustaining medication,
and having to give her samples, 
just so that she doesn't 
end up in the hospital again.
Health care is the only industry, I think,
that we really turn customers away. 
We could do better as providers. 
We can buck the system and change it.
- After working 
at a hospital for four years, 
Dr. Wong decided to quit his job 
and open his own primary care 
clinic in Pittsburgh.
He's one of a growing number 
of doctors who are looking
for ways to cut the 
insurance companies out.
Not taking insurance is a defiance 
because it's against the traditional 
way we do things.
- Health insurance is a 
trillion-dollar industry in the U.S. 
And profits are on the rise,
but medical costs keep going up.
And by taking this insurance,
we also get paid by the insurance.
So, they become our masters 
in a lot of ways.
- Dr. Wong is able to treat the vast majority
of routine ailments 
as a primary care doctor,
but can't provide emergency care 
or specialist expertise.
That means all of Dr. Wong’s patients 
pay a flat fee of $35
for primary care and 
$10 for each additional ailment.
There are no hidden fees, copays 
or bills that show up in the mail later.
$35 might be more than you paid 
for your last doctors visit, 
but consider all the other potential fees 
associated with insurance.
Copays are the set amount you pay 
for doctors visits and prescriptions,
plus premiums every month 
to insurance companies.
Deductibles are how much you pay 
out-of-pocket each year
before your coverage kicks in.
Coinsurances are a percentage you pay
even after your deductible has been met.
Health care pricing is just confusing.
It’s like not knowing how much 
a hamburger costs
until after you’ve already eaten it.
And Dr. Wong believes you don't need 
insurance to cover basic care, like
stitches, flu shots or a sprained ankle.
Part of our philosophy is 
to keep things simple,
but also to keep our costs low,
so that we can pass that off to patients.
- Dr. Wong is the only employee.
There’s no receptionist, nurse or assistant.
Patients sign in on an iPad 
and wait until he calls them in.
I was at work,
put my finger in the mixer, 
and it's smashed.
- Brent drove over an hour 
to get to the iHealth Clinic.
I've dealt with this kind of injury before.
I've paid thousands of dollars,
even with my insurance.
Last time was actually 
$750 out-of-pocket
for two stitches.
- The most Dr. Wong says
he's charged a patient?
$55.
That doesn’t include things 
like testing or medication.
But he works with patients 
to find affordable options.
I think a true primary care provider 
is a patient's advocate.
- Dr. Wong says he used to 
do a lot of extra work
just for insurance companies.
It was almost to the point where 
I would tell the patients,
you know what? I'll do this after you leave.
There's really nothing 
I'm doing face-to-face with you
that's providing you a benefit.
I'm just, you know, 
working on the computer
or filling out forms that 
the insurance wanted.
- Both the endless paperwork and 
emotional stress Dr. Wong experienced
while working with insurance companies 
led him to feel burnt out.
More than half of U.S. doctors 
have reported symptoms of burnout.
Physician burnout, or burnout 
in the health care industry,
is called by other people moral injury.
And moral injury occurs 
when we are asked every day,
and constantly, to do something 
that is against our morals. 
- While Dr. Wong doesn’t want 
to work with insurance companies, 
he acknowledges that his clinic is not 
a replacement for insurance coverage.
Catastrophic care is very important.
You don't want to go into personal debt,
you know, for a lifetime 
because of an accident 
when an insurance 
could have covered that.
- The American Medical Association 
hasn’t taken a stance
on doctors cutting out 
insurance companies,
but says it supports their right to choose.
But I think a lot of providers 
don't realize that this model exists, 
and it could fit them very well. 
They might not get paid as much, 
but their job satisfaction gets better. 
- There’s not enough data yet on 
the long-term impact of models like this.
But Dr. Wong believes 
he’s already making a difference.
We can decrease the cost of care.
We can increase efficiency.
We can increase access of primary care 
and urgent care services
to those who need it. 
And I think you can 
improve people's lives that way.
- At his last job, 
Dr. Wong says he was lucky 
to get a handshake from a patient.
I've never had such gratitude from patients.
Just this week, I saw someone drive by
and give me the thumbs-up
as I was closing the door
because I think she kind of knew about 
what we were trying to do here. 
If I have a 1% chance
of changing the health care system 
for the better,
it is a worthwhile endeavor. 
Hey everyone, it's Adrienne.
Has health insurance, or the lack of it, 
affected you or someone you care about?
We want to hear from you 
in the comments below.
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