We desperately need change in the US healthcare system.
There are two ways to go about this: top level congressional legislation lobbying, bottom level grassroots disruptive change. Both are important, but they are very different.
Top level congressional lobbying can definitely cause significant change, by changing the laws. This is needed, such as in the state of NY to allow DPC doctors not to be hamstring by existing laws meant for insurance companies. The problem is that this route requires you to go head to head against the hospital, pharma, and insurance lobbies who are more resource rich than any group of physicians and providers will ever be. An example is that Obama care covered more people while keeping the status quo the same. This is like fighting a polar bear with only your fists.
The bottom level grassroots disruptive change is much more insidious and much harder for industry to fight head on. Disruption is removing the hospital systems and insurance companies from the picture entirely. Many providers including myself are already doing this by forming direct contracting/cash practices. As the grassroots movement grows, the above industries will be disrupted and lose business as they find they are no longer needed as much as they once were. They will have to change or risk insolvency. This is the route that I choose. I hope more will join.
