The following testimony related to direct primary care agreements was submitted to both the Assembly Committee on Health, Aging and Long-Term Care and the Senate Committee on Health on Feb. 12, 2025.
Feb. 12, 2025
ASSEMBLY BILL 8, SENATE BILL 4
Thank you for considering this extremely important piece of legislation on direct primary care. The Badger Institute is wholeheartedly in support. In fact, we have been pushing for a path toward direct primary care in this state for years for a fundamental reason: Healthcare in Wisconsin is too expensive and in decline.
We are now ranked 33rd in heath outcomes, according to America’s Health Rankings — a precipitous drop from prior years.
Wisconsin’s ranking for children’s health outcomes is even worse, dropping to a record low of 39th in 2024.
Health costs, meanwhile, have soared. Our state has the highest hospital costs in the Midwest — and sixth highest in the country, according to the latest independent RAND Corporation report.
We’re not alone. A December 2024 Gallup report showed record dissatisfaction with the health system nationally because of rising costs, denials by insurance companies, and a failure of the public health profession’s handling of COVID.
Fortunately, Wisconsin has excellent physicians, nurses and other health professionals who can help get us back on track. Direct primary care is one way to accomplish that.
Direct primary care is healthcare directly from a provider to a patient, bought with cash instead of insurance. It is different than “concierge medicine,” typically less expensive, with monthly fees of $50 to $150. In exchange, a patient can readily access a wide range of primary care services, personalized and comprehensive, without the high copays and deductibles now typical of insurance.
While it can mean lower costs, the first advantage is its focus on the relationship between patient and provider, with the delivery of a personalized and comprehensive experience preferred by patients.
And by providers: It means care delivered without the intervention of insurance and insurance’s bureaucracy — the “medical industrial complex,” as former American Medical Association president Barbara McAneny called it.
DPC has been catching on, with average annual growth of 36% per year reported as of 2022. There are now more than 2,400 DPC practices nationwide, including many in Wisconsin.
DPC and insurance are complementary: Patients can use insurance for costly procedures outside the scope of routine primary care. For most care, however, no approvals are needed, so care can be obtained faster and at lower cost.
DPC is not meant to replace insurance, and it is not insurance — so it should not be regulated as if it were insurance. Such a regulatory assumption would restrict providers’ flexibility to innovate the model, and it would negate at least some of DPC’s cost and service advantages.
DPC legislation in Wisconsin
More than 30 other states have already enacted laws similar to the one now again being considered in Wisconsin. A similar bill was considered in the last session but failed to make it out of the Senate.
There’s good reason to hope it has more success this time around. It is good for consumers to learn that they can sometimes pay cash and sometimes use insurance, and that the two approaches are complementary. While incumbent players in an anticompetitive healthcare system might resist, direct payment will control costs while also empowering patients, physicians and employers that pay for benefits.
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