The Slippery Slope of Insurance Based Care
By Shaw Kuster, MD | Louisville, Colorado | October 28, 2025
Have you ever wondered why it takes weeks to see your doctor, why every test or procedure seems to come with an extra charge, or why your visits feel rushed and impersonal?
Much of this frustration can be traced back to the pressures that come with insurance-based healthcare.
This is a complex issue with many moving parts, but here’s a simplified look at how the traditional insurance model affects both patients and physicians—and why more people are turning to Direct Primary Care (DPC) as a better alternative.
The Hidden Costs of Accepting Insurance
For a medical practice to accept insurance, it must maintain a large administrative team to handle billing, coding, and compliance. Physicians also have to document visits in highly specific ways to get reimbursed properly, which leads to more time on the computer clicking boxes, and less time face to face with a patient.
If a patient declines a recommended screening, can’t afford certain medications, or doesn’t meet insurance-driven “treatment goals” (like blood pressure or blood sugar targets), the clinic can actually be paid less overall.
At the same time, reimbursement rates from insurance companies continue to shrink, while overhead costs keep rising. The result?
Doctors must see more patients each day just to keep the doors open. More patients mean less time per visit, more time spent charting, and less direct, meaningful interaction between doctor and patient.
Consolidation and Loss of Choice
In recent years, many insurance companies have started buying up clinics, hospitals, pharmacies, and physician groups. While this might sound efficient, it actually decreases competition and limits patient choice.
For example, if an insurance company owns its own pharmacies, it may restrict coverage to those locations—forcing patients to switch pharmacies or pay much higher out-of-pocket prices elsewhere. This financial pressure often leads to the closure of independent pharmacies, further reducing options for patients and communities.
Ironically, many people now find that paying cash for common prescriptions—like antibiotics or blood pressure medications—can be cheaper than using insurance.
Paying More, Getting Less
Despite high monthly premiums, copays, and deductibles, many patients feel they’re not getting real value from their insurance. The system often contributes to higher costs, lower quality of care, and fewer choices—all while increasing physician burnout and administrative waste.
A Better Way: Direct Primary Care
That’s where Direct Primary Care (DPC) comes in. At Abide Health, we’ve chosen a simpler, more transparent model that puts patients—not insurance companies—at the center of care.
Here’s how it works:
No insurance billing: We don’t spend hours fighting with insurance companies or filling out endless paperwork. That means lower overhead and more time for you.
Smaller patient panels: Because we don’t have to see 20+ patients a day, our doctors can spend more time with each patient, offering thorough, unhurried visits.
Simple monthly membership: One affordable monthly fee covers your primary care. You can reach out by phone, text, or video for small issues—without worrying about surprise bills or copays.
Accessible, relationship-based care: We focus on long-term health and prevention, not rushed visits or insurance checkboxes.
The Bottom Line
Direct Primary Care isn’t a cure-all for every issue in the healthcare system—but it’s a meaningful step toward a more personal, transparent, and sustainable model of care.
At Abide Health, our mission is simple: to bring healthcare back to what it should be—a trusted partnership between you and your doctor.
