Category: Healthcare In the News

Medicare for All Act of 2019


16 July 2019

Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being. 

In this blog post, I will not discuss my personal political views nor will I use this as a medium for healthcare horror stories, like this sad story, this sad story, or this frustrating story… because we have heard these before. In this blog I will discuss facts of what I learned from 1) attending the EMU hosted event for ‘Medicare for All,’ and 2) reading through all the pages available online regarding H.R. 1384.

Medicare for All 

I recently attended a town hall hosted at Eastern Michigan University (EMU) on Saturday July 13th where Congresswoman Debbie Dingell (Michigan’s 12th District), Congresswoman Primila Jayapal (State of Washington 7th District), State Senator Jeff Irwin (Michigan’s 18th Senate District), State Representative Yousef Rabhi (Michigan’s 53rd District), State Representative Ronnie Peterson (Michigan’s 54th District), as well as Michigan Nurse Association Vice President Katie Scott were all discussing the ‘Medicare for All Act of 2019.’

They were having a discussion about H.R. 1384, the Medicare for All Act of 2019 which is a bill that would establish a national health insurance program to cover all U.S. residents. Currently (as of 7/15/19) the bill has 117 co-sponsors. 

Speaker Panel Talking Points

To start with the discussion at EMU, I always appreciate an elected officials time (especially on a Saturday night) to discuss what impacts our community. Yes, they did start the panel discussion late, exactly 20 minutes- much like an overfilled physicians waiting room. However, much like those doctors we want to see, we can look past that.

To briefly summarize what they discussed, I felt the panel discussion had an overall vibe of a small group rally for the ‘Medicare for All Act’ with very little substance discussed. To be fair, each speaker only had about 5 minutes. However, 5 minutes should be enough time to pitch something they want to sell. And let’s be honest, our elected officials were trying to sell this bill to the room.

Debbie Dingell

To start with Congresswoman Debbie Dingell’s talk, it was heavy on current healthcare disparity statistics in the US. She did offer some brief talking points such as “We are going to a single billing system that will eliminate a lot of costs.”

The bill claims savings of $500+ billion annually from reductions in costs of billing and administrative costs.

As you can see below of the graph of physicians and administrators from 1970 to 2009, administrative costs are having a major impact on healthcare spending. 

I am curious to see how exactly they will implement this administrative cost savings. Does this mean simply cutting back (i.e.- firing) extra staffing? Those are jobs too. Many physician offices utilize administrative staffing such as front desk receptionists, a dedicated phone staff, nurse triage staff, laboratory staff, billing staff, imaging staff, medical record staff, transcription staff, and office management. 

Primila Jayapal

Congresswoman Primila Jayapal was next. Seattle, you should be proud, you elected a great official. I would be proud to have her represent me if I were there. I was impressed because I felt she actually covered more substance in her discussion than any of the other speakers regarding the ‘Medicare for All Act.’ She states the act will have four components:

  1. Cover Everyone ( Dr. O’Boyle likes this )
  2. No copays or deductibles and be able to go to any doctor or hospital you want to.
  3. Comprehensive coverage including primary care, vision, dental, substance abuse, mental health, maternal care, and more.
  4. Control costs.

Yay! Some material I can work with. Then congresswoman Jayapal says with these ‘controlled costs’ we will pay 14% less then now. WHAT! 14% ?? So that MRI, instead of being $1,400 is now $200 less? That colonoscopy that is billed at $5,000 is now only $4,300. This cost savings is not significant nor will it move the economic needle of medical costs.

Reading through H.R. 1384, I could honestly find only one section (616): Payments for Prescription Drugs and Approved Devices and Equipment that discussed any effort to reduce healthcare expenditure.

Has she heard of Direct Primary Care (DPC)? Does she know I can get a member an MRI for $300, or a colonoscopy for $700? Direct Primary Care is moving the needle on medical cost economics by saving our patients anywhere from 50-90% off of insurance billed costs.

Jeff Irwin

Michigan State Senator Jeff Irwin spoke next. Again, a good speaker. He discussed how doctors are fighting insurance companies over billing and how much a wasteful system this results in. Senator Irwin did say something I believe is important when discussing healthcare: speaking about what people value in their health and healthcare coverage. But, nothing that added any insight on the actual bill. 

Yousef Rabhi

State Representative Yousef Rabhi discussed efforts from a Michigan effort to start universal healthcare plan called ‘MiCare.’ In an acknowledgement of supporting information to Representative Rabhi, he did discuss how he plans to fund MiCare through a vote of the people in Michigan for progressive taxation. Yet, to be fair to the audience, I felt his talk was a bit of a curve ball as all other speakers were focused on the federal bill and not the state bill. 

Ronnie Peterson

State Representative Ronnie Peterson added some personal stories about his history of fighting for racial equality and now fighting for healthcare equality. Again, his talk was touching but added no material onto why or how the ‘Medicare for All Act’ would work.

Katie Scott

The last speaker was Katie Scott, the vice-president of the Michigan Nursing Association. From her talk, I was able to pick out that she was an Intensive Care Unit  (ICU) nurse. Again with the story telling theme of the night, she gave a personal narrative of high prescription drug costs and how that impacted her. 

I absolutely love what nurses do and think their roles are critical towards healthcare. However, ICU nurses and the need they fill are vastly different than what primary care doctors see and what a vast majority of people experience when we think of and utilize healthcare. 

If the elected officials pushing for the ‘Medicare for All Act’ want to be serious, they need to get feedback and collaborate with the primary care providers out there already making changes in their communities. Instead of pushing for town halls on why we need change, Direct Primary Doctors are having town halls in communities on how we are already changing healthcare to improve patient access, improve price transparency, and reduce out of pocket costs on everything from office visits, medications, imaging, speciality care, and laboratory studies.

In-House Medication Dispensary Saves Money


10 October 2018

Did Beyond Primary Care mention that we have an in-house medication dispensary that saves money to our patients? Check out the pricing comparison of a common antibiotic, Penicillin, that is used for many ailments such as strep throat. Don’t worry if you have a penicillin allergy, we have affordable alternatives also! This can save our patients hundreds, if not thousands of dollars a year. How you may ask?


We buy medications wholesale. We then have our drug control license, that many traditional doctor offices refuse to get either due to contractual or logistic limitations. Another advantage of enrolling with a Direct Primary Care doctor. We then of course pass the savings on to you!


If you want to think differently about health care come join us! Not only are we personable, we work hard to save our patient’s $$$$.

Insured but Worried about Rising Health Care Costs


9 October 2018

At Beyond Primary Care, we hear this story a lot: “I am insured but am worried about rising health care costs.” Employees are paying more for health insurance face serious concerns about how they will pay their medical bills in the event they actually need care. For example, more and more people are enrolled in plans with high deductibles. In 2010, one in 10 workers with single-person health insurance coverage had a plan that required a deductible of $2,000 or more. By 2018, one in four did.

Traditional doctor’s offices, where charges are often opaque and disclosed only after services are rendered, leave many people apprehensive about actually using their insurance. In an August 2018 survey, 37 percent of people with employer coverage said they have received a bill for health care costs that they were NOT expecting. Either because they thought their insurance would cover it, or the insurer would foot a larger part of the bill.

Patient’s preferences- for convenience, fast but thorough service, connectivity and price transparency- are making many adults with employer-sponsored insurance turn towards a constellation of alternative services as they face rising costs. Healthy employees still need coordinated and longitudinal care, someone who knows them. A recent report in JAMA Internal Medicine found that nearly half of patients who sought treatment at an urgent care clinic for a cold, the flu, or similar respiratory ailment left with an unnecessary and potentially harmful prescription for antibiotics.

It doesn’t have to be this way. With an employer sponsored membership at Beyond Primary Care, our goal is to maximize employee health and minimize costs. Please contact us today or make an appointment to learn more about Beyond Primary Care.

Direct Primary Care is NOT Concierge Medicine


3 October 2018

In this video I am answering a common question that I receive, so much so that I have added it to my FAQ page, and that is what are the differences between Direct Primary Care medicine and Concierge Medicine? A lot of people may unknowingly alternate between these terms, but these terms are not synonymous.


Direct Primary Care’s goal is to return as much value to our patients in exchange for the membership by being transparent about the true costs of services. Think Southwest Airlines,” as way of comparison. Southwest provides air travel accessible to everyone with a whole different vibe.” With Direct Primary Care, and specifically Beyond Primary Care in Ann Arbor, practices aren’t “changing the medicine, but changing the way we consume it.”



Direct Primary Care, Explained.


2 October 2018

Hi and thank you for your interest in Direct Primary Care (DPC). Our clinic, Beyond Primary Care, is part of a doctor movement to improve access to our patients. Patients get more personalized care. Patients may also save money on insurance if they can pair their direct primary care membership with a cheaper, high-deductible policy.


The main reason many people cannot afford health care is because it’s too dang expensive. Most patients will seek DPC because they could not afford insurance premiums and/or out-of-pocket expenses under the current system. Watch me explain more about Direct Primary Care and how patients can save money.


Direct Primary Care is NOT insurance. In fact, we recommend all our patients have some type of insurance as accidents may happen. Insurance is absolutely necessary for certain types of care. Some events and conditions are inherently expensive. However, hypertension management and radiation treatment for brain cancer are radically different things. Why should we pay for them in the exact same manner? With Beyond Primary Care, I am delivering a higher level of care at a known priceIf you can not afford insurance, direct primary care is an affordable healthcare option.