Excerpt from “Membership Medicine: When the Doctor Is Always In”:
At just 20 years old, membership medicine still carries a lot of controversy and questions.
There’s the long-expressed concern that it could lead to a two-tiered health system, in which poorer people are shut out of the premier slots. But not as often brought up is the question of favoritism. Might a membership system favor younger, healthier patients over older people or those with chronic illness? Even now, it’s common for practices to charge older people higher membership fees than younger ones.
And, while the traditional fee-for-service system can allegedly lead to overtreatment and rising costs, what happens when practices don’t make money on tests and procedures—or when they include them as-needed in the memberships? Could that incentivize some doctors to provide less care than warranted, swinging the pendulum too far back?