Select Page

It may not surprise you that people in the wealthier class and who have “Cadillac” health insurance policies get better medical care than those with smaller bank accounts, weaker insurance policies or no coverage at all.

The widening gap between the rich and middle class and/or poor has produced a relatively new phenomenon in health care called Concierge Care. The simplest definition of concierge care is when people in the Top 1% of the population pay an additional upfront fee –- over and above any other health cost –- to get direct and greater access to their doctor of choice.

The concierge medical model began to emerge in the mid-1990s when a Seattle medical provider introduced what it called its “luxury medical care” model. MD2 International focused on patients paying up to $25,000 a year for a “boutique healthcare experience.” Yes, this cost was over and above payments for things like hospitalization and private consultations.

While most concierge arrangements are not that pricey today, the idea for this type of medical delivery service has spread widely. A low-end concierge arrangement can be as little as $199 – but the average today is from $1,500 to $2,400 per year.

Approximately 12,000 physicians practice concierge medicine today. That’s a tiny fraction of the more than one million licensed doctors in the U.S. A concierge doctor averages treating 400 to 600 patients annually while a typical general practitioner might see 2,500 patients per year.

It’s a situation with profound implications for the overall health care delivery system in our country. While concierge care is obviously the best situation for those who can afford it, it exacerbates many of the basic problems the majority of Americans face.

For example, doctors are highly incentivized to work a lot less and earn a lot more by treating fewer patients who can pay more. That has created a considerable problem with doctor shortages in rural areas and poorer inner-city urban areas.

Large medical providers that are publicly traded companies are highly incentivized to adopt concierge models because they can deliver more profits to their shareholders. This creates pressure to drive the establishment of more health care facilities designed to serve the wealthy while leaving average Americans to increasingly scramble to find good doctors.

In short, concierge care is yet another way that our society is being divided along lines of levels of wealth and “have and have-not” situations.