Health Care In The News

We have been delighted with our health care options since moving to the Puget Sound area. We were initially attracted to the Everett Clinic for its close location, convenience of walk-in service, and its obvious efficiency with lab on-site. The clinic and its physicians are also affiliated with Providence Regional Medical Center in Everett, one of the top hospitals in the greater Seattle area and consistently ranked in the top 100 nationwide.

In order to have access to the EC, I needed to subscribe to a Medicare Advantage Plan, because the clinic chooses not deal with Medicare directly. I went to meetings where the handful of private contractors presented their plans. One stood out, Essence Health Care, and I signed up.

With Essence advantage plan, I still pay only my basic Medicare premium, less than $100 per month deducted from my Social Security income. I pay no extra drug premiums as I used to. My drugs are very inexpensive, $5 for the generics and $20 for the pricey ones each month, totaling around $50 per month. Visits to the walk-in clinic and to my primary care physician (PCP) are each $10. Visits to specialists are $25. That’s it. For a measly $150 a month plus visit copays, I have medical care that is unsurpassed in my experience, for much less than I was paying in So. Cal. And, an extra of the Essence plan is coverage for regular eye exams and dental exams/cleanings.

The EC physicians are outstanding. My PCP is a delight. I also have an excellent orthopod, GI guy, opthalmologist, dermatologist and MOHS specialist. I don’t need to get authorization to visit the specialists, although we ask the PCP for recommendations. The EC has all medical records on-line, so any time I visit a physician, all my other physicians can see the result as well. I can see my results on-line via the Internet. I can also e-mail questions to any of my doctors and get answers back in a day. For all my visits, my average wait is less than 10 min and longest I recall is 20 min. For me, that respect for the customer is unheard of; I feel pampered. I am additionally pampered by Debby, who schedules all my appointments and goes with me to many of my visits; I feel loved.

Medicare advantage plans have a built-in subsidy from the government that will go away under the health care reform bill. But if Essence has to pass some of this loss on to us, it will not upset us, for the result should still be less than straight Medicare. Considering the quality and value of the service, if I pay more it will still seem like a steal. Essence is said to have been created by a physicians group. It is the only case I have encountered in my life where adding a middle man actually saved the consumer money. Whatever their model, I wonder why it isn’t widely emulated and touted by the Government.

This morning’s local paper tells us the Everett model has been noticed in the wider community. PBS is filming a special about America’s Best Kept Health Secrets, for airing at the end of the year. Medicare costs in Everett are an astounding 35% of those in pricey areas such as Miami, and journalists are wondering why and investigating. There are other efficient systems operating in other areas of the country and these are being covered as part of the good news story.

Both Harvard and Dartmouth have been looking at a country-wide assessment of health care quality vs. cost for the last two years. They instructed the journalists to check out the good news coming from Everett. The EC is one of ten nationwide that stands out for having come so far along the path to affordable medical care. Providence Medical Center is likewise studied for its facilities and innovations in cardiac care. We are blessed.

2011 Follow-on: Essence declined to renew its plan in our county, so I had to switch to another provider, Group Health. They’re considerably pricier, but so far the quality of service remains very high and the value is still good. And as a bonus, I get a free membership to my local YMCA, with a pool, gym, and exercise programs for all abilities, Health care doesn’t need to be expensive. I have the evidence in hand.

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