Smash Notes
How doctors can help low-income patients (and still make a profit) | P.J. Parmar
Modern American health care is defined by its high costs, high overhead and inaccessibility -- especially for low-income patients. What if we could redesign the system to serve the poor and still have doctors make money? In an eye-opening (and surprisingly funny) talk, physician P.J. Parmar shares the story of the clinic he founded in Colorado, where he…
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Notes
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It's because Medicaid pays less than private insurances. Also, Medicaid patients are shown as more challenging patients. Some show up late for appointments, some don’t speak English, and some have trouble following instructions.
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His medical team has served more than 50,000 medical refugee visits. 90% of his patients have Medicaid and most of the rest, he sees for free.
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Parmar paints a picture of a patient that has no phone minutes or phone access. She takes the bus because she cannot drive, and she has disability family members or young children to take care of. This scenario is the reason why there are no appointments. The patient shows up when she wants and is able to.
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On TED Talks Daily, P.J. Parmar says his clinic at Mango House is cheaper than the places his patients would otherwise go. The clinic serves about 15,000 refugees a year at a lower cost than that alternative. He does not take the profit home. He puts it back into the refugee community as a business expense, paying for food, clothing, an after-school program, English classes, and other services run by tenant groups in the building. He calls the model social service arbitrage: using inefficiencies in American health care to serve people who are poor. Doing it as a private clinic, he adds, means taxes, legal exposure, and Medicaid rates that move.
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The only way we are going to bridge the underserved medicine gap is by seeing this as an opportunity. In order to bridge the inequality gap, we have to recognize our privileges and use them to help others.
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