AUSTIN – Today, the Texas Public Policy Foundation’s Right on Healthcare initiative published the policy perspective Choosing Your Care: How Direct Care Can Give Patients More Choice.

“Over the past several decades in the United States, the healthcare industry has become increasingly dominated by third-party payers,” said David Balat, director of the Right on Healthcare initiative at the Texas Public Policy Foundation. “The United States healthcare system hasn’t always been dominated by third-party payers but has become distorted from many years of government regulations.”

Third-party payers are any entity, other than the patient, that reimburses healthcare providers for their services. They include insurance companies, employers, the federal government, and state governments through Medicare and Medicaid.

“The current system with heavy influence of third-party payers under government mandates is the source of many frustrations,” said Stephen Pickett, Ph.D., healthcare economist with the Texas Public Policy Foundation. “For most people, their health coverage is tied to their employer, making it more difficult to change jobs. Prices for healthcare are typically unknown before a procedure for patients and even providers, leading to surprise bills after procedures are done.”

To address many of these frustrations caused by third-party payers, many patients and doctors have found it easier to bypass this system entirely. Medical practices that do this are broadly referred to as direct care.

“Direct care practices seek to resolve the flaws of recent years by providing transparent pricing and strengthening the doctor-patient relationship,” said Elizabeth O’Connor, legislative fellow at the Texas Public Policy Foundation. “Direct care has gained momentum in primary care, surgery, pharmaceuticals, and dentistry and, while it functions differently in each setting, the central idea is that third-party payers are not involved and prices are known before the patient sees the medical professional.”

“The current healthcare system as it stands is not working for many Americans,” continued Balat. “Awareness of direct care can limit the current prominence of third-party payers, encourage competition, and give patients more control of their healthcare.”

To read the perspective in full, please visit: