No insurance? No problem: People joining health co-ops

No insurance? No problem: People joining health co-ops »Play Video

One in three adults in Oregon under the age of 65 didn't have health insurance at some point last year.

That begs the question, where are they going when they get sick? We found some alternatives springing up to serve those people so they can get health coverage that doesn’t cost them an arm and a leg.

Alesha Adamson is one of those people. We caught up tagged along with her on a recent visit to her doctor at the Multnomah Family Care Clinic. It's allergy season and she knows what's coming.

“I'd like to avoid the infection. I tend to get a sinus infection every year,” she said.

Adamson doesn't have health insurance. She's self-employed as a consultant and says she can't afford it.

That’s why she joined a local health co-op, the Patient/Physician Cooperatives of Portland. For anywhere from $40 to $95 a month, she gets access to the co-op's doctors, dentists, chiropractors and other providers, as well as discounts on prescription drugs.

“The kind of people we attract right now are the people who have no other form of insurance. They have no other way to get to health care, and often they put off getting taken care of because it's expensive,” explained Tony McCormick, the co-op’s founder.

He said the kind of providers the co-op attracts are people like Dr. Kirsten Carr who are tired of the production mode of medicine.

She started her own practice in Southwest Portland after working at a conventional clinic for years.

“It was definitely encouraged for me to be seeing up to 30 patients a day [at her previous job] and this was in a seven-hour shift,” Carr said. “so on days in the winter, when everyone was sick, I was seeing patients every ten or 15 minutes.”

Adamson points out that there is no Consumer Reports for health care. This is her way of not being a disenfranchised consumer.

“A lot of people think their only option is to either go to emergency room or urgent care,” Carr said. “What they don't realize is that they’re often paying more than they would end up paying in a doctor's office with cash.”

Across town in Tigard, former emergency room physician Dr. Robert Tilley is operating primarily in cash at the Affordable Health Clinic he founded with his wife, Cecilia. The clinic charges $67 per visit.

The Tilleys said they're able to keep their costs low by avoiding the complexity of dealing with insurance, collections agencies and the related overhead.

They order x-rays and lab tests, and get better rates on those because they've negotiated with the providers. Those are all savings they pass along to the patient.

The Tilleys poured their savings into the venture with the goal of serving the uninsured.

“As the insurance companies close their grips, it becomes harder and harder if you've got a preexisting condition to get insurance. Well, that's a little unfair,” said Robert Tilley. “If you have an ankle injury and you lose your insurance, now you'll never be insurable for that ankle ever again. There's something not right about that.”

He’s hoping to show this is a viable model, which means more doctors would follow suit.

“If more doctors do this, more people get care, and perhaps the insurers will realize they don't run everything,” Tilley said.

It’s his way of bucking the system while netting the rewards of helping those in need.

Cecelia Tilley said on multiple occasions patients are so grateful they cry.

“One lady started to just shake and said, ’No one's ever done this, bless your heart,’” she said. “It's heartwarming. It breaks your heart and it’s heartwarming all at the same time.”

Robert Tilley said he and his wife have re-cooped their entire initial investment and funded expansion. Month-to-month they’re operating completely in the black.

They even have patients coming in who have health insurance, but have co-pays or deductibles that are so high, they prefer just paying the $67 flat fee for a visit.

Tilley said his Tigard clinic has done so well that he and his wife are expanding to a second location in Estacada.

There is an important caveat, however, if you’re considering a medical co-op. These health care options do not provide coverage for medical catastrophes.

That means you're still at risk of getting huge bills if, for example, you get in a major car accident. There are also additional fees that can apply for medical services not performed in the doctor’s office.

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