MedLogic

Health insurance open enrollment is upon us again and it is time to familiarize yourself with pricing and options. 

I want you to know that you don’t have to settle for ridiculously high premiums you can not afford that don’t really cover anything you need anyway.  You don’t need a plan with a deductible so high that it makes your mortgage seem cheap.  You don’t have to have a plan that traps you into a “network”.  You can do better. 

There is exciting news for health care mandates too: beginning January 1, 2019 the individual mandate penalty for NOT having health insurance will be zero. 

This is exciting because you can finally go without health “insurance” and pursue other options.

Health Shares are becoming a more popular option for many people.  I like the idea that you are paying into a risk share pool and your money is going towards other members health care needs (think of a co-op).  With traditional insurance, about 20% of your premium goes towards profits, operating costs and compliance with government regulations.  Another 20% go to prescription drug costs which means profits for PBMs (Pharmacy Benefit Managers) such as CVS Caremark, Express Scripts, United Health care and Walgreens is working on launching one as well with Blue Cross Blue Shield.  PBMs are probably the biggest racket in healthcare in terms of price manipulation.  Finally, another 20% go toward “outpatient services” which is largely labs and imaging.  This means that roughly 60% of your premiums go towards goods, services, profits and administrative costs.  Of those costs for goods and services, you can do about 70-90% better.  Of the administrative costs, you can do 50-60% better.

In other words, you are most likely vastly overpaying for health care goods and services if you have traditional insurance exclusively.

What are the alternatives?

For individuals:

A DPC (Direct Primary Care) + a catastrophic coverage plan or a DPC + health share plan

Health shares include Medishare, Christian Sharing Ministries and Liberty Health Share.  Liberty Health share will reimburse you a portion of your membership fee if you are a MedLogic DPC member.

Another option is Sedara Health which offers various levels of deductibles (called the unshared amount in health sharing terms).

Joining a Primary Care DPC such as MedLogic Primary Care plus a Health Share is a total healthcare solution.  This combination is a financially savvy way to have full comprehensive coverage: You are covered for outpatient primary care through your MedLogic monthly premium and you have a cost sharing plan for any services that are required outside this scope such as an ER visit, major or minor surgery, childbirth and pregnancy care, cancer treatments and more.  Check out our website today for all our services that are included for free in your membership.  We offer deep discounts (70-90%) on labs, imaging and medications to our members as well.  In many cases, membership pays for itself in terms of cost savings on medications, imaging and labs.  If our care can help you to avoid an ER visit, you could save an entire year worth of membership fees.

For example, a 35-year-old would have a total monthly cost of $194 per month for an individual coverage ($72 per month for MedLogic + $122 per month for Sedara Health).

Learn more about MedLogic DPC here:
www.MedLogicMD.com

Learn more about Sedara Health + DPC here:

https://sedera.com/dpc/

Try out different pricing combinations here:

https://sedera.com/dpc2/

Learn more about Liberty Health Share here:

https://www.libertyhealthshare.org/3-program-options **

(** Liberty Health Share will reimburse  you up to $40/mo individuals, $60/mo couples, $75/mo families if you are MedLogic Member)

For Small Businesses with 5-150 employees:

Please contact us directly to learn how you can cap your business’s health care premium expenditure, having a fixed cost that does not increase year over year and a cap on total health care cost liability.  We can show you how!

Call or email us today at MedLogic Primary care: office@MedLogicMD.com or 847-881-6858

Happy saving everyone!

Jill Green MD

My hold time was over 20 minutes when I finally got through to my son's pediatrician office, only to have the human voice I had waited so long for bark at me "Name and date of birth".  Many more questions and patient identifiers later, I was allowed to state why I was calling.  I had a concern about my son and was asking to be seen that week.  Next available appointment with my pediatrician?  4 months.  My frustration was through the roof.  As both a patient, mother and physician, I was done with health care.  When I first learned about direct primary care or DPC in 2013, I thought it was too good to be true.  Now, nearly 2 years into my own DPC practice, I realize that it is a little hidden gem that it is making healthcare great again.  What do I mean by great?  Affordable, transparent pricing, much fewer hassles in setting up appointments or obtaining care, the ease of getting care over the phone or while traveling away, talking to a real person when you call and so much more. 

The hashtags #takebackmedicine and #bethechange are seen widely throughout the DPC community as primary care physicians like myself have pushed back against the traditional model of churn and burn that we know doesn’t work and we know isn’t providing the best care for our patients.  Whether its pay for performance or a volume driven metric being shoved at us, physicians are tired of being squeezed by third parties from all sides: insurance companies, pharmacy benefit managers, big hospital conglomerates, CMS/Medicare.  When you cut these middlemen out of our relationship- the one between doctor and patient- you are left with a simple solution to a problem that gives many worry: how to get good affordable healthcare.  DPC is that answer. 

So what is DPC?  Admittedly even though I have been involved with DPC for the past 5 years, my own husband still occasionally has questions, so I realize change takes time for acceptance.  However, I would leave the practice of medicine rather than go back “in the system” that I know doesn’t work and can’t work for my patients because it is not physician driven, it is dollar driven and there are too many drivers in the driver’s seat.

DPC simply put is a low cost monthly membership fee charged by your doctor that allows the member (you, the patient) to get care from me, the doctor, without the interference of third parties.  This means same or next day visits for urgent care problems by a physician who knows you (no 2-hour urgent care wait for a doc in the box or expensive ER visit because it’s 10pm and you need care).  This means seeing the same physician every time and me getting to know you and what you need and how you approach your care.  This means the same real person picking up the phone when you call.  Beyond just great access to care when you need it, it also means saving you lots of money, which often makes that small monthly fee pay for itself.   While paying a monthly fee to your doctor is a new concept, it allows me to run the practice with very small overhead and pass on cost savings directly to you.   That cost is about $2.46 a day for the average adult and ¢65 cents per day for children under 18. 

How can you save with DPC?  Well for one, price transparency.  I can tell you exactly how much something will cost before you do it, so you can manage your healthcare costs.  Need a cholesterol test?  $4.44.  Need a blood count panel? $1.04.  Need a mammogram?  $90.

Do you need something expensive like an MRI?  You will be surprised to find out they aren’t as expensive as your insurance and hospital conglomerate would have you believe- $295.  By the way, a typical hospital charge would be around $3,000 or more so if your deducible is $5000, then that $295 MRI will cost you $3000.  Even if your deductible is $500, you’re still overpaying.   What if you’ve already met your deductible and you just have to pay your co-insurance rate of 10-15%?  Yes, you are still paying the full actual cost and more of the test.  In other words, you’re paying 100% of the actual cost plus more.  I could on and on (cholesterol medication: $1.93 for 1 month, depression medication: $0.90 for one month, EKG: free in my office, getting stiches: $15 in my office).  Hopefully you can see how paying a little up front can save you tons down the road- kind of like how insurance is supposed to work.  Best of all, you get the added benefit of being part of a small intimate practice where we know you well and we aren’t too busy to care for you.  We do this same price transparency and cost savings for prescription and over the counter medications (a bottle of 100 Tylenol is $0.78).  The money you save between labs, imaging and medications more than covers your monthly membership fee.  What about people who only come to the doctor once a year or even less and never need any labs, imaging or medications?  Those people pay the monthly membership fee as a hedge against not having to access costlier insurance based or emergency room care.  If this is you and you still think DPC doesn’t make good economic sense, you are gambling.  Even healthy “never get sick” types get sick, get cancer, need stiches or get appendicitis.  Believe me, I do this all-day long.  You’re worth the $2.46 a day and your kid is worth the ¢65.

DPC isn’t the perfect solution in every situation and I acknowledge that, but it is far far better than the alternative: being stuck in a murky, rigid and costly system that is in a death spiral.  #Bethechange

We’ve been in the height of flu season for a few weeks now.  Both Wisconsin and Illinois are at the highest level of activity classification as reported by the CDC.  I’ve been hearing a lot of misconceptions tossed around about the flu, more so this year as it has been more severe.  Here a few quick flu facts to familiarize yourself with:

1)     The flu vaccine is effective.  It is not intended to prevent flu.  It is intended to lessen the severity of illness, shorten the duration of illness, lower the complication rate and prevent death from flu and its complications.  Every year I hear that the vaccine “is not very effective” because so many people are getting the flu.  I also hear that the vaccine “is only 10% effective”.  This statistic comes from the ability of the flu vaccine to completely prevent infection is you are exposed to flu.  In about 10% of people, it will prevent infection.  In the vast majority, it will not.  The main purpose of the vaccine is to lessen duration and severity and prevent death.

2)     Most flu is influenza A and B.  Most seasons, it is influenza A.  This season, it is … surprise surprise … about 90% influenza A.  These are in the flu shots and subtypable.

3)     Most flu deaths are in unvaccinated individuals.   Getting the vaccine prepares your immune system to recognize the flu or its variations (there are many flu subtypes of A and B) and start an immune response.  This shortens the duration, severity and prevents death (see #1).  There are still flu deaths in vaccinated individuals however, but it is less common.

4)     While everyone should get the flu vaccine, for these groups of people it is especially important: Infants 6 months and older, babies, toddlers, children, adolescents, people with lung disease (asthma, COPD, emphysema), people with chronic illnesses like diabetes, people who are immune suppressed, anyone taking chronic prednisone or other immunosuppressive drugs, pregnant women at any gestational age, the elderly.  These groups are especially vulnerable to flu complications and flu death. 

5)     The following people should also get the flu vaccine: any person who works with, volunteers with or lives with someone in #3.  Be a good Samaritan. 

6)     Tamiflu is indicated for prophylaxis in flu cases for high risk groups.  It is not recommended for the general public or healthy adults. 

7)     This flu season only, the CDC did update its guidelines expanding the use of Tamiflu beyond the first 48 hours of symptoms to high risk individuals

8)     Its not too late to get a flu vaccine this season.  Flu season goes well into April.  It does take about 2 weeks post vaccination to have antibodies to provide protection.

9)     Getting the flu vaccine cannot give you the flu.   It’s not a live vaccine.  I am not going to spend any more time on this one but please feel free to reach out to me if you have questions on this. 

10)  You can get flu like symptoms after getting the vaccine.  You do not have the flu.  You can get an immune response for 24 to max 48 hours that feels like a mild flu.  You also can of course get the real flu since you have not built immunity for at least 2 weeks after vaccination (see #8), in other words, you can have unfortunate timing.

11)  Even people with allergies to egg- even anaphylactic allergies to egg- can get the flu vaccine.  Yes, they’ve studied this.  Talk to your allergist if you fall into this category. 

12)  There can be serious flu vaccine complications, namely GBS (Guillian Barre Syndrome) – this is a rare complication.  It is about one in a million.  Myself being on the wrong side of one in a million, I can tell you that if you are the one, it is life-changing.  In happier news, a few times a year someone manages to pick the winning lottery numbers so it’s not always a bad thing to be the one in a million.

*** disclaimer: I am in no way interested in non-productive feedback, personal thoughts or feelings as I know there are strong ones out there.  This post is intended to clear up misconceptions, not open debates based on what happened to your best friend’s sister’s cousin 10 years ago when they got the flu vaccine… or didn’t get it.  Stay healthy this season everyone and be kind to one another!

It's hard to believe MedLogic is turning ONE July 5th!  This past year has been incredibly rewarding, fun and challenging all at the same time.

We have exponentially grown this past year and opened our second location this past April in Kenosha, WI.  For now, we are going to focus on these two locations while we catch our breath.   Our main goal is to provide good quality care and time to each of you.  That is why we will stop taking new patients completely at around 600 patients and joining MedLogic will then be by waitlist only.  By keeping our practice small, we will still have the time with each of you that we value.

A few things I wanted to say and reflect on about this past year:

Laura, my practice manager and Michele, my Nurse Practioner are both completely and totally amazing.  They are some of the smartest, dedicated and most fun women to work with and it has been such a pleasure building this practice with them.  They keep me sane and grounded.  I literally could not have built our practice to what it is today and what it will be in future years to come without these two amazing ladies.  They also literally keep the practice running on a daily basis.  We have had definitely had a learning curve for running a practice but these two are on it.  A huge THANK YOU to these smart women.  I am totally humbled by their hard work.

Another huge thank you to my husband.  If Laura and Michele keep me sane and grounded at work, my husband keeps me sane and grounded at home.  He has been incredibly supportive in helping to guide me as I started by own practice for the first time.  As someone who has had his own business for the past 12 years, he has been extremely helpful in guiding me along through the craziness of trying to get everything to come together.  He also did a lot of the build out in our new Bannockburn location so I am excited for you all to see our new office soon.  We are still waiting on some furniture delivery and then I will post pictures.

On a personal note, working out of the traditional health care system has been a blessing.  I can tell you that the amount of paper work that I used to fill out in a day at my old practice, I now fill out in about 4-5 months.  All of this extra time now goes to: more time with my patients, more time researching new medical studies and staying up to date with current practices.  The amount of time spent on the phone begging PBMs (pharmacy benefit managers like ExpressScripts or CareMark) or insurance companies is 1% of what it used to be.  Again, more time to actually practice medicine and be a doctor.  I am really happy with the Direct Primary Care approach.  I have also seen my family more in the past year as well, so personally, this model of care has been very meaningful.

Now about you guys:  we have really enjoyed getting to know you all- some families and individuals we know really well and others, we have enjoyed being here for you when you need us.  Our youngest patient is now 7 months old and our oldest patient is 92!  We have a few babies, lots of kids and some teenagers as well.  You are spread across 2 states from Milwaukee to Chicago to Rockford and everywhere in between. 

A huge THANK YOU to you all.

Happy 1st birthday MedLogic!

Jill Green MD

This blog post is more of a collection of resources that EVERYONE who even looks at water this summer should familiarize themselves with to stay safe and help keep others safe.

Swimming season opened just one short week ago Memorial Day weekend and I have already seen two cases of near drowning in the hospital.  This is something that can happen to anyone- adults and children.

This first link is recognizing a drowning victim- please read!  Just like real life CPR looks NOTHING like it does in the movies, neither does drowning.

http://mariovittone.com/2010/05/154/

Consider having a water watcher.  This website has a ton of great resources organized by age on water safety tips. (check out the side bar for the age based resources)

https://www.safekids.org/other-resource/water-watcher-card

Finally, if you recognize a swimmer in distress, you need to call for help to safely help them.  DO NOT just jump into the water.  This article reviews why you need to have a plan before you try to help and why swimming to the distressed person is extremely dangerous.  Know how to help successfully.

http://io9.gizmodo.com/why-rescuers-die-while-drowning-victims-survive-1680233920

Finally, I have NO financial interest in this product but this was designed by two parents who are Emergency Medicine Physicians and through their years in practice have encountered too many tragedies involving drowning.  This device is pricey, but I would consider it if you have a pool, pond or lake on your property.

https://www.sealswimsafe.com/how-it-works/

Swim safe everyone!

Dr. Green

A quick blog post about taking care of your most valuable asset- you!

I’m going to give 10 quick tips of things that you should be focusing on to live longer and live better.  If you’re gonna live past 90, you might as well feel good and live gracefully!

1)      Drink 2 Liters of water a day.  How much is 2 Liters?  Think of the big coke bottles- that’s 2 Liters.  But don’t ever by that junk.  Seriously.  You need water to live- this is well documented.  You don’t need coffee, coke, juice, milk or energy drinks to live.

2)      Sleep.  A great goal is 7-9 hours per day depending on your individual needs. This could be 7 hours at night with a daily 1 hour nap like our European friends or 8 hours per night.  When I cut out all sugar and do a cleanse, I feel great on only 7 hours of sleep.  When I’m in normal mode, I need 8 hours.  Everyone is different but everyone does need sleep.  You will die if you don’t sleep.  Check out this fascinating but horrible rare genetic disease, fatal familial insomnia, and notice the word “fatal”.  https://en.wikipedia.org/wiki/Fatal_familial_insomnia

3)      Walk.  If you are over 15 months old, you should be walking somewhere every day.  Do what you need to do to get it done:  Park farther away, get a dog or a stroller, grab a friend, wear sneakers… but truly we are supposed to be moving around more than we do.  Thirty minutes a day or 150 min per week is essential.  Your great grandma wasn’t sitting around watching Netflix.

4)      Brush & Floss.  People loathe flossing for some reason.  Yes, it is time consuming and slightly annoying, but I promise you it is a snap compared to taking care of dentures.  If you don’t think you have time to take care of your teeth, be prepared to take much longer taking care of your dentures.

5)      Work less.  Americans are obsessed with working and purposely try to do things to make it look like they are working if they aren’t.  It seems like it is shameful to be off work enjoying something else.  At the end of life, no one wishes they had gone to the office more…

6)      Smile.  Did you know babies smile 300-400 times a day and that we adults only muster up 20 smiles per day on average?  Not only is smiling nature’s anti-depressant, but people will respond more positively to you as well.  Twenty is such an abysmally small number.  Smile at 10 people today.  In fact, smile at the next person you see after reading this.

7)      Live within your means.  There are an astonishing 7.5 BILLION people living on Earth.  Only one person on earth can claim the title of being the poorest person on Earth and only one person can claim the title of being the richest (Good ol’ Billy Gates at $76 billion dollars!)  That means the rest of us 7+ billion people are all somewhere in the middle together.  Don’t buy a car, purse, vacation house that you can’t afford.  It will just create stress and unhappiness.   Nothing you buy today will be around in 500 years anyway. 

8)      Eat food.  See my other blog post on this.  Cheetos are not food.

9)      Put on your happy pants.  It turns out that whining, complaining and jealously are actually bad for your health.  They raise your blood pressure and release cortisol which does all sorts of bad things.  Eckhart Tolle said, “To complain is always non-acceptance of what is.  Change the situation or accept it”

10)   See your doc regularly.  Things are always changing in medicine.  Seeing your doc regularly will keep you up to date on all the health screening you need for preventative medicine.  Everything from vaccines to mammograms to colon cancer screening. 

If you are doing less than these 10 things, try adding ONE thing from this list above today…and don’t forget to smile at the next person you see!

Jill Green MD