Insurance Status Quo
The Status Quo Problem
I like status quo as long as it is good. For example, weekly worship in the church ought to be ordinary and predictable. However, if the church is a facade filled with people not living as they ought during the week, then that institution needs disruption. The status quo allows people to coast; which is fine if we’re coasting in a good direction. But if we’re not, the coasting needs to be arrested so a different path can be taken. Healthcare faces this problem, and it’s time to change course.
If people do not start taking responsibility for their own healthcare, we will eventually see our current trajectory lead to a government healthcare system that does not allow private practice in any way. If the status quo is maintained, I predict that in 20-30 years, private medicine will go the way of the DoDo, and the US will be similar to Canada.
For my generation, maintaining the status quo would be easy; I could likely retire comfortably in 20 years. But should things stay this way? I find it soul destroying to maintain a broken system that will eventually lead to a worse system. My duty to society and particularly my children is to course correct rather than coast, even though coasting would likely work out fine for me.
How did we get on this path and why is it leading toward government healthcare?
The Insurance Mindset
The infrastructure we are all participating in is driven by profit, not true health. But I contend that this profit-driven, opaque (confusing) system is conditioning us to accept something worse. When insurance companies inflate costs, deny coverage, and leave patients with impossible bills, people naturally conclude that private healthcare has failed because no one can afford it. And the government waits in the wings as the solution. Direct government control through taxation would be simpler than the current complex system. Therefore, the current system serves a purpose: it makes government control look like relief rather than overreach. This is how the playbook works:
Step One: People are conditioned to believe healthcare is an inalienable human right. The fact that pharmaceutical companies and surgery centers make people pay for healthcare they need is presented as simply wrong; a failure of capitalism.
Step Two: Employers are forced to provide health insurance for their workforce, ostensibly to make oppressive capitalists care for their employees. The result is that people don’t pay attention to how much is spent on healthcare each year. It’s taken out pretax, and their employer pays a significant portion that would otherwise be available as wages.
Step Three: We now have a population who doesn’t see the money leaving their paycheck and who assumes healthcare is their divine right. When the medical system is presented as run by corrupt, profit-driven corporations, when insurance coverage falls through and people are stuck with bills, when copays and deductibles keep rising, the government waits in the wings promising to fix it all. You can see how easy it would be for the population to not only allow but to demand that government take over healthcare.
For example, the average employer in 2025 contributed around $20,000 toward the family plan premium, with the employee covering around $6,000—a total of $26,000 annually (KFF, 2025). Yet most people only experience the $15-20 copay or their deductible. They don't feel the weight of this cost because it comes out pretax.
So, insurance creates a steady income stream that enables providers to charge prices consumers would never pay directly. The result is systemic cost inflation that remains hidden from individual patients.
By paying for insurance through our employers, we perpetuate the inaccessibility and exorbitant prices of healthcare. We allow insurance and the government to be the gatekeepers of our healthcare access while believing we are saving money despite paying $26,000/year for healthcare.
All of this creates the perception that justifies government intervention: Corporations are oppressing people out of their right to healthcare through a confusing insurance system, and even when care can be accessed, prices are exorbitant. This perception leads to the conclusion that healthcare is too expensive and inaccessible for private markets to handle.
But is that actually the case?
What the Problem Raises
How do we address the accessibility and quality of healthcare without involving our tax dollars and government?
The first step is to return to the idea that the average healthcare service is affordable and available. If you need to see a doctor for your sinus infection, how much should that service be worth? Do you really need insurance to talk to a provider for 15 minutes and get a prescription?
We need two things to change. We need providers to treat their services like any business treats its services, and we need consumers to work directly with providers rather than using insurance as a middleman.
This model addresses routine care: the sinus infections, ear infections, annual checkups, and chronic disease management that make up the vast majority of healthcare encounters. This is where pricing transparency and competition matter most.
I’m not proposing to solve catastrophic healthcare yet. That’s beyond the scope of a single primary care practice and an area where insurance may still be warranted. But by separating routine care from catastrophic coverage, we restore price transparency where it’s most needed.
Transparency creates competition. When patients can see that Provider A charges $75 for the same service Provider B charges $150, they’ll choose Provider A. Then quality becomes essential; poor service means lost business. This is how the free market is supposed to work.
My small attempt to contribute
My new practice seeks to establish this: the average healthcare service is accessible and affordable. I’m not inventing this model. Direct primary care practices are proving this across the country. But I’m helping bring it to Western NY.
If enough providers adopt this model for routine care, the market will naturally create catastrophic-only insurance plans because that’s what the market will demand. But someone has to demonstrate it’s possible. That’s what I’m attempting to do.
So, if you believe healthcare should be transparent and affordable, participating in direct-pay care is how you participate in fixing this system. By choosing a provider who operates this way, you’re voting with your dollars for a better healthcare model and potentially saving thousands of dollars per year yourself.
My practice operates on this direct-pay model. If this resonates with you, if you want healthcare that’s transparent, priced fairly, and focused on what you actually need, then schedule an appointment today.
Urgent Visit – $40 (typically 15 minutes)
Comprehensive Evaluation – $200 (typically 45 minutes)
More to come by God’s grace.
References
KFF. (2025, October 22). 2025 employer health benefits survey. KFF. https://www.kff.org/health-costs/2025-employer-health-benefits-survey/