HELENA, Mont. (April 25, 2017) – Montana Gov. Steve Bullock vetoed a bill that would have helped facilitate healthcare freedom and set the stage to nullify national healthcare in practice in the state.

Sen. Cary Smith (R-Billings) sponsored Senate Bill 100 (SB100). The legislation specified that direct primary care agreements (sometimes called medical retainer agreements) do not constitute insurance. Had the bill been signed into law, it would have freed doctors and patients entering into such agreements from the onerous requirements and regulations under the state insurance code.

In his veto letter, Bullock makes the preposterous argument that facilitating direct primary care agreements “offers little or no value to most customers.”

“SB 100 is bad for Montanans because it allows providers to charge unnecessary fees for services already covered by insurance and fails to deliver the administrative savings it promises,”

Shouldn’t Montanan doctors and patients decide that for themselves? Since when it is the state’s job to decide if a product or service offers them value or not? Is it the government’s role to decide what what type of relationship a doctor and patient should have?

Apparently Bullock thinks so.

Bullock’s sentiments are precisely the opposite of those of Jack Spencer at the Michigan Capitol Confidential. Spencer argues that eliminating the third party payer helps both physicians and patients minimize costs.

He writes:

“Under medical retainer agreements, patients make monthly payments to a physician who in return agrees to provide a menu of routine services at no extra charge. Because no insurance company stands between patient and doctor, the hassles and expense of bureaucratic red tape are eliminated, which have resulted in dramatic cost reductions. Routine primary care services (and the bureaucracy required to reimburse them) are estimated to consume 40 cents out of every dollar spent on insurance policies, so lower premiums for a given amount of coverage are another potential benefit.”

In fact, direct patient/doctor agreements allow a system uncontrolled by government imposed insurance regulations to develop. It makes doctors responsive to patients, not insurance company bureaucrats or government rule-makers. Allowing patients to contract directly with doctors via medical retainer agreements opens the market. Under such agreements, market forces set price for services based on demand instead of relying on central planners with a political agenda. The end-result will be better care delivered at a lower cost.

This represents the kind of cost control Obamacare promised, but failed to deliver. Last fall, Tom Woods interviewed a Kansas doctor who utilizes the direct primary care model. Dr. Josh Umbehr’s practice demonstrates the cost savings possible when doctor’s are unfettered from the bureaucratic health insurance system.

By incentivizing creative healthcare solutions, the market will naturally provide better options, such as the Surgery Center of Oklahoma, This facility operates completely outside of the insurance system, providing a low-cost alternative for many surgical procedures. A more open healthcare marketplace within a state will help spur de facto nullification the federal program by providing an affordable alternative. As patients flock to these arrangements and others spurred by ingenuity and market forces, the old system will begin to crumble.

Perhaps that is why motivates politicians such as Bullock to vote as they do. Politicians seem to like the status quo.

Montanans deserve full healthcare freedom, and the governor’s veto vote was a step in the opposite direction.


TJ Martinell

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