Well, chickens-to-be, at least.
Dr. Rutten Wasson, 42, is a throwback to a time before HMOs, electronic health records and hospitals with fountains in their lobbies. She sees patients the same day they call if she's not booked up, spends at least a half-hour per visit -- compared to the more typical 15 minutes -- and usually charges only $50 for a consultation. She takes cash or check, but no insurance -- and sometimes accepts gratuities of a dozen fresh eggs or a pie.
Where is this? Sharon Angle's hometown in Nevada? No, rural Minnesota.
In rural Minnesota, where there are too few doctors to treat a sparse, aging population, being creative is both more possible and an imperative.
Compared to other doctors, says Rutten Wasson, "I don't waste anywhere near as much time on paperwork. Yes, I do other things. I take out my own trash. I clean my own instruments. I clean my own toilets." She prefers this to working within the insurance system. "I'm autonomous. I don't let third-party payers or clinic staff get between me and the patient."
How did Dr. Wasson end up in this now-antiquated role as a doctor who makes house calls and whose customers pay in cash and foodstuffs?
Her first job as a physician was with Allina Hospitals & Clinics in the Twin Cities.
It didn't take long before Rutten Wasson became disenchanted. She was shocked to learn how much money the clinic brought in. "They made four times what they were paying me. I looked at that and thought, where is the money going? Rent can't be that high. I had the most hideous art and ugly furniture. My assistant wasn't paid that much. Where is it all going?"
She answers her own question. "It was going to administration, tiers and tiers and tiers of management, all of whom were busy making rules to make them look busy. Mostly they made my job more difficult."
Can you say "Single payer health care?" I knew you could. Can you say "Doctors being doctors without massive amounts of paperwork?" I knew you could say that too. But you know what really got to Dr. Wasson before she struck out on her own?
... she couldn't give a break to patients without insurance. "It's hideously unfair that uninsured people are given a bill for $375 and are expected to pay the whole thing, while the insurance company pays between 60 and 75 percent. It's not right. People without insurance are subsidizing people who have it.
You want to pay cash? You pay more! You want to spare the clinic the overhead of dealing with insurance companies? You pay more! And we keep asking ourselves why the cost of health care in this country is twice that of other industrialized nations. Sheesh.
Rutten Wasson's practice hasn't made her rich. She leads a modest life on a fixer-upper farm with her husband, Rud, who is a Lutheran pastor, and their daughter Sarah. Yet, she says, "I'm not going to raise my rates. Some of my patients are on medical assistance or on fixed incomes. They couldn't afford to come if I raised my rates. I'm not going to be buying a yacht anytime soon. But we're comfortable."
Obviously to have an advanced health care system we need specialists. And modern, expensive equipment along with state-of-the-art diagnostic labratories. But perhaps we would better off with a few more Dr. Wasson's as well.