Doctor takes scalpel to insurance

A Wisconsin physician has started a practice that does not take insurance, which he says drives up the cost of health care.

January 4, 2011 

GREEN LAKE, Wis. -- Tall and folksy, Thomas Willett is the living, breathing definition of a country doctor.

For decades, he has tended the aches and pains of patients who live on farms and in small cities and communities across a lush, rolling stretch of Wisconsin.

But little did anyone here know that beneath the doctor's calm, authoritative demeanor beat the heart of an honest-to-goodness radical out to change America's health care system one patient at a time.

For the past seven months, Willett has been engaged in a remarkable experiment to bring affordable health care to those who need it most, patients who either have no insurance or only catastrophic coverage.

What he has done is create a clinic with reduced rates, a tiny staff and one very prominent feature: He doesn't accept insurance. He has cleared away the back-office overhead required for the care and financial feeding of the health insurance industry and passed on the savings to the patients.

Need a 15-minute checkup? That'll be $39. The rates are set right where the patients can see them, in an easy-to-understand two-page menu. Prices range from an $8 blood draw to a vasectomy for $500. He doesn't prescribe narcotics. He'll take cash, check, credit card or debit card.

"I'm independent, and everyone else works for the man," Willett said with a broad smile on his face.

He's giving this experiment two years, roughly the time it takes to establish a practice in a small town. He wants to see if he can deliver the lower-cost care to the patients while also making a living. Don't worry for him, though. He's 68 and financially set after a long, successful career.

And he hasn't turned away his longtime patients, either, although an area hospital handles the back-office insurance work.

So far, through word of mouth and two advertisements in a local paper, he has attracted 70 patients a month to the new practice, called Access Affordable Healthcare.

The clinic has drawn attention of state Sen. Luther Olsen, R-Ripon, who represents the area.

"He's an honest, real guy," Olsen said of Willett. "He just wants to see if this will work. He's genuine."

Olsen recently invited Willett to testify before a Special Committee on Health Care Access in Milwaukee. Willett lightened the mood when he told the panel: "This is going to be refreshing for you. I'm going to save you money. I'm not going to ask you for money."

Willett has been stewing about the health care system for years. He expressed his frustration with his longtime office manager Holly Thorp and her son, Andrew, a nurse who now attends medical school and helped him craft the plan for the clinic.

Willett often lamented how much his own health insurance premiums cost, saying, "This is really stupid. What did medicine cost when I started?"

He looked at his own office.

"I have 62 percent overhead," Willett says. "So, I work until the end of July, seven months, for nothing. If you cut out all that stuff, that is what medicine is worth."

Some parts of overhead can't be cut. Buildings cost money to buy and maintain. Good staff costs money, too. But Willett zeroed in on two items: billing and third-party payment -- the insurance coding, claim filing and appeals that tend to swell the back offices of medical practices.

Cut the overhead and he could cut prices by up to two-thirds. Moreover, his salary could remain the same. He would charge only what he was receiving from insurance companies, through their reimbursement.

At least, that's the theory.

He doesn't know if it will work. And he doesn't know if the model could be applied to Medicaid and Medicare patients. After all, those programs require record keeping.

"The big debate in health care is if it's a patient's right or not to get medical care," he said. "Yeah, that's one thing I wish we could take care of every patient. On the other side, you're in a capitalist system. Why should we abandon that system? Or, is there another way without involving the government to get health care to everyone."

Right now, he's making a big difference in the lives of his patients who otherwise might not be able to afford medical care.

Some of his longtime patients, who are no longer insured, now see him in the new program.

Jodi Jaeger, 62, a breast-cancer survivor, likes the peace of mind of knowing exactly how much an exam will cost.

"You're paying for what you get," she said. "You're not paying for the paperwork. You're here, you pay and you're done."

Guy Rossberg, 62, a cancer survivor, comes to the office frequently to have his blood tested -- a substitute, albeit an imperfect one, for a far more expensive CT scan that he cannot afford.

"People around town can't believe they can see a doc for $39," he said.

Linda Rather, 53, an independent crop consultant, says she can get her blood work done through the clinic for half the normal going rate.

"Doc Willett is someone you can implicitly trust," she said. "He doesn't beat around the bush and waste time but he takes time. He gives it to you straight."

Willett is hopeful that the plan will work. And, if it doesn't, he says he won't have any regrets.

"I work for the people," he said. "I try to work for the patients."

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