Medicare vs. Direct Primary Care: A Generational Perspective

"The true measure of any society can be found in how it treats its most vulnerable members." — Mahatma Gandhi

Although we’re Millennials, we often feel like we have the souls of Baby Boomers. We deeply value respect for our elders and empathize with patients who struggle with Medicare.

One of the biggest issues with Medicare is that many physicians no longer accept it. Why? Because Medicare reimbursement rates are notoriously low, and the administrative burdens are incredibly high. For many doctors, the cost—both in time and compliance—of seeing Medicare patients simply isn’t sustainable.

So what happens when a Medicare patient’s physician retires and they start looking for a new provider—only to find that few, if any, are accepting Medicare? It’s a serious problem, especially in places like Hawaii, where the population is aging rapidly.

We believe that Direct Primary Care (DPC) can be part of the solution.

To be clear: we do not interface with Medicare. If you have Medicare and would like to see us, you’ll need to sign a waiver that states you, the patient, and we, the physicians, agree not to bill Medicare for any services provided.

Why would someone choose this route?

First and foremost, it gives Medicare patients an option. Some physicians who do accept Medicare are legally restricted from charging patients to "jump the line" or expedite care. These rules were put in place to prevent financial exploitation—but they also limit flexibility and access.

Second, the insurance-based model—Medicare included—often creates financial disincentives for physicians to focus on preventive care and long-term health outcomes. Instead, the system rewards checking administrative boxes over actually keeping patients well.

In contrast, DPC removes those barriers. It offers a more personal, accessible, and preventive approach to care—especially for those who feel stuck in the current Medicare system.