When the New England Journal of Medicine publishes an op-ed arguing that direct primary care is a danger to the “common good,” what they really mean is: too many doctors are opting out of the game.
This episode of The Doctor’s Lounge isn’t just a rebuttal.
It’s a war cry.
Four practicing physicians dismantle the academic hypocrisy, expose the Medicaid industrial complex, and ask the question no one in Washington will:
What happens when the safety net becomes a subsidy machine?
This is not a debate about compassion—it’s about control.
What You’ll Learn in This Episode
1. NEJM’s flawed moral logic
The panel dissects an op-ed labeling DPC as harmful to access, without addressing how the current system is driving doctors out of practice altogether.
2. DPC is a correction, not a luxury
Direct primary care isn’t a boutique service for the rich. It’s an escape hatch from price-fixing, bureaucracy, and burnout.
3. Medicaid is no longer a safety net
Over 60% of Medicaid funds now support “optional” populations. This isn’t targeted care—it’s strategic federal drawdowns.
4. Managed Medicaid is a cash machine
Centene covers 15 million lives and generates nearly $18,000 in annual revenue per member. The goal isn’t better health—it’s higher PMPM.
5. States are gaming the system
Double enrollment, cross-state billing, and lax verification cost taxpayers billions, and no one is accountable.
6. A better model already exists
For less than $7,000 per year, a DPC, catastrophic plan, and HSA combo can deliver care and build wealth. Instead, we shovel money to middlemen.
7. Academic hypocrisy is the real access issue
The same MD-PhDs warning about “access” helped design the price controls and coding systems that gutted primary care. They don’t see patients. They write policy.
Three Quotes to Chew On
“Primary care doctors are getting paid less than plumbers—and somehow they’re the ones being blamed.”
“If Medicaid were truly a safety net, why are insurers profiting like it’s Wall Street?”
“The moment patients control the money, the system collapses—and that’s what terrifies them.”
Listen to the full episode. Then share it with someone who still thinks nonprofit means benevolent.
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