Mr. Chairman and Mr. Stark:

Thank you for inviting me to testify before this committee today.

I am grateful that our leaders want to know what is happening at the grassroots level and that you are willing to consider the perspective of an ordinary primary care physician like me when deliberating healthcare policy.  

I am Dr. Robert Berry and my background is Primary Care Internal Medicine and Emergency Medicine.  As a physician in a private practice that does not take any insurance, I believe I might be able to offer you fresh insights on some of the seemingly insurmountable problems we face in healthcare today. 

Over three years ago, I left ER medicine to start a clinic primarily for the uninsured of my community.  I thought I might be able to help them avoid unnecessary, expensive visits to the ER.  My motivation was simply to try and flesh out in my own life an answer to the age-old question, “Who is my neighbor?” 

Of course, I don’t refuse other patients willing to do “Payment At The Moment Of Service.”  In fact, because this seemed to be the unifying theme of our practice, I chose its acronym PATMOS as the name for the clinic.

PATMOS is similar to charity clinics such as Dr. Eck’s in that it serves many patients falling through the cracks of our broken healthcare system – except we don’t receive any taxpayers’ funds either directly as subsidies or indirectly as a tax-exempt corporation.  It is similar to boutique clinics such as Dr. Kaminetsky’s in that it contracts directly with its patients – except that most of our patients don’t have insurance.

The prices for medical services at our clinic are really quite reasonable.  $35 for a sore throat.  $95 for a simple laceration.  I can keep my fees this low – and thus affordable to the uninsured and patients with high deductibles – because I avoid the crushing overhead and hassles of processing relatively small medical claims – a service from which they clearly do not benefit.

Mine is only one of many non-boutique, cash-only clinics in this country.  There is a growing movement of physicians like me who offer affordable, quality medical care by refusing to sign insurance contracts.  We are no longer willing to tolerate anyone intruding into the once sacred doctor-patient relationship.   

And the mainstream media is catching on.

Last November, the Wall Street Journal featured our clinic on the center of its front page in an article entitled “Pay-as-You-Go M.D.: The Doctor Is In, But Insurance Is Out.”  Just several weeks ago, the AP News ran a story on SimpleCare, a network of cash-only clinics, which was picked up by CNN and many local media throughout the country.  National news programs have highlighted other cash-only clinics as well. 

The media is tapping into a rich vein of frustration and fear.  Frustration with costs escalating and no end in sight while medical care is becoming less accessible and less personal.  Fear that we might end up with a single payer system where delays for treatment can be inhumane.  Clinics such as ours offer hope that there are doctors out there today who care and who don’t cost an arm and a leg.

In Canada, the median time from a mammogram to a mastectomy is 14 weeks.  Personally, I don’t think I could look a woman in the eye, inform her that her mammogram was suspicious for cancer, and then have to tell her that the cancer might have spread before she can receive treatment.  Of course, in Canada, I wouldn’t be put to that task because clinics such as mine are currently illegal there. 

The issue before you now, it appears, is very simple – “who will control healthcare dollars?” 

The government?  No – medical decisions are much to complex and personal to entrust to distant bureaucrats, many of whom lack basic medical knowledge.

How about patients, then?  In my opinion, the most cost-effective and humane solution to many of our healthcare problems is to allow ordinary Americans to manage their own routine medical care by giving them control over healthcare dollars.  They can do this now with pre-tax, tax-deferred personal and family medical accounts within consumer driven health plans and spend them at clinics like ours.

It is, after all, their money and their health.  They should control both.

Ronald Reagan once said, “There are no easy solutions.  Just simple ones.”  All they require is being a neighbor.

Congressional Testimony
April 28, 2004- Oral