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No Insurance, No Problem. A Kirkland Doctor Avoids the Middle Man with Simple Care

A group of Washington doctors have banded together to form a group that provides quality care at a fair price by cutting out insurance companies. (AP image)

Thirteen years ago, Kirkland family practitioner Dr. Vern Cherewatenko came up with something called Simple Care. It's not new, but I have never heard of it. So I thought maybe you haven't either.

The concept, like the name implies, is simple. Doctors who use Simple Care don't deal with insurance companies. They get paid directly by the patient.

"We could probably cut our prices in half if patients would just pay the doctor upfront," Dr. Vern says he realized. "And so we did that. The simplest transaction between a patient and a doctor: The patient chooses a doc they want to go to, the doctor charges a fair price, the patient pays him, and we're done with the visit."

Patients pay $29 a year to belong to the network, and then office visits are charged based on time spent with the doctor.

"Ours is not a discount plan. Ours is a fair price plan. I'm happy to get $75 for my visit because that's based on time. If I spent twice as much time, it'd be twice as much money. So it's very time oriented. Patients like that. It's kind of a pay as you go."

Dr. Vern's $6 million, 30,000 patient office went bankrupt in the 90's, and he blames leeching insurance companies. Now that he has cut ties with them, he says he earns more money.

"When a doctor has to bill an insurance company, he has to have five employees. If he doesn't have to do any insurance billing, he can save three employees. So we just pass that savings on to the patient."

Simple Care's website shows 656 doctors in-network in Washington State alone, and Dr. Vern has a packet of information that patients can bring to a doctor to recommend they try Simple Care. Doctors are welcome to continue accepting insurance plans but also practice Simple Care.

"Simple Care doesn't tell doctors what their fees should be. Simple Care doesn't regulate that at all. The docs are free to charge what they feel is their best price. If you go to that doctor and he's good, you'll come back."

Family practitioners, chiropractors, dentists and all kinds of specialists use Simple Care, but Dr. Vern also recommends getting catastrophic insurance. But he says Simple Care is still beneficial to both patients and doctors when someone without insurance needs a more serious, and expensive, procedure.

"This neurosurgeon said, 'Well, you're a family doctor but I'm a neurosurgeon. I cut into people's brains. That can't possibly work for me.' I said, 'How much do you charge for cutting into people's brains?' So he says, '$3,600.' I say, 'How much do you get paid by your best insurance company?' 'Like, $1,200.' So I said, 'Ok, let me understand this. You charge $3,600, you get reimbursed $1,200. What if, in the Simple Care network, I was able to refer you a patient who was willing to pay you cash, and was willing to pay you $2,500 for the surgery?' He goes, 'That would be great!' I go, 'That would be Simple Care.'"

Dr Vern has made it his mission to make sure people can get affordable health care.

"We even have a program called Cares For America. I wanted to be able to do something for Aunt Jessie, that doesn't have a dime to her name. So I said, 'Aunt Jessie, you come to me, I'll take care of you. But I'll give you 90 days to volunteer time. You volunteer somewhere, at your church, at the school, read to kids, I don't care. Just come in and we'll credit you $10 an hour for every hour that you volunteered.' They don't get it for free so they feel like they really get care with dignity."

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