Hampden Doctor ditching health insurance

HAMPDEN, Maine (NEWS CENTER) -- Dr. Leigh "Jack" Forbush of the Osteopathic Center For Family Medicine has decided to ditch health insurance. The Hampden Physician says he became too frustrated with the health insurance industry and adopted a direct pay model for primary care.

The atmosphere at Doctor Forbush's office is pretty laid back. Zeke and Zulu, two black labs have free reign of the office. Most days, Doctor Forbush, known by many of his patients simply as Jack, doesn't wear a tie. Kids feel right at home playing in the waiting room. That's the draw for Kim and Adam Barber and their four boys, Owen 5, Evan 3, Noah 1, and newest addition, Joel, who is 2 and a half weeks old.

"we consider him family and he considers us family," Kim explained.

They've been coming to Dr. Forbush's office for the past 5 years and paying for their health care through Adams Work Sponsored plan. That is until Dr. Forbush forced the Barbers and his other patients to make a decision.

"I guess I was a little concerned at first ," Adam said.

They were concerned because beginning in January, Dr. Forbush stopped accepting health insurance of any kind. He created his own direct payment model for care.

"Our healthcare environment has become so beauracratic and so bogged down with regulation that it's impossible for me to provide efficient cost effective care. That i have to spend half my time on the phone arguing with someone who is not a doctor that you need a certain treatment or test," explained Dr. Forbush.

He says he spent 15 to 20 hours a week on the phone battling with insurance companies for his patients. Now he can spend that time doing what he loves.

"From a selfish perspective I want to get off the phone and get back into the examination room."

Dr. Forbush's direct care plan charges one annual fee to his patients. A family plan costs $1500 dollars and that covers all preventative care visits. There is a $35 dollar co-pay for other office visits, and he offers his patients discounts for prescription drugs and labs.

Dr. Forbush asks his patients to think of him like an auto mechanic. You'd pay your mechanic for routine maintenance like oil changes and tire rotations and tuneups and your auto insurance would cover you if you got into a big accident or wreck.
he recomends his patients sign up with his practice for their basic needs, and that they also buy a catastrophic insurance policy to cover their bigger medical expenses. He says he can provide a cost competitve product.

"Eliminating all those middle men getting rid of them completely and just contracting with a patient drops my costs or the expenses i have to incur by two thirds. So I can provide a service for one third the price essentially," he said.

Kim and Adam Barber say they ditched Adam's work sponsored plan, signed up with Dr. Forbush and got a catastrophic plan and they did save some money.

But some of his other patients are paying more. Chris Blackie is a Forest Service Pilot, and his wife works for Umaine. They have good insurance coverage through the state, that they decided to keep. But they also decided to stick with Dr. Forbush.

"It was the personalization of being with Jack and knowing what i'm going to get here and knowing that i'm going to be with the same doctor every time."

It isn't a plan for everyone . Dr. Forbush says he's lost some patients, but he thinks this will be the better plan in the long run.

American Health Insurance Plans, a lobbying group for the insurance industry did not appear overly concerned that the direct pay model would be of any threat to the health insurance industry. Susan Pisano, a spokesperson for AHIP stressed that the majority of physicians continue to contract with at least one insurer.

"It continues to be the case that the overwhelming number of physicians are contracting with health insurers. This is just another option that a few physicians are choosing to use." Pisano said.

NEWS CENTER knows of one other primary care physician in Maine, Doctor Michael Ciampi in South Portland who has moved to a direct pay model.

Dr. Forbush is hosting a questiona and answer session on Saturday May 3rd from 11:00 a.m. - 1:00 p.m. at the Church of the Open Door in Hampden to explain his direct pay model for care to anyone who is interested.


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