First, Do No Harm

In the finest tradition of politics--if it moves; tax it, if it keeps moving; regulate it--the Washington State legislature can't take people solving their own problems:

For years, doctors who started so-called "concierge" medical practices, offering personalized care in return for fixed retainer fees, have existed in legal limbo.

State regulators have argued that the arrangement is essentially medical insurance and should be subject to the same rules. Doctors and patients insist it's the antithesis of insurance: middleman-free deals between patients and doctors.

....In Washington, Senate Bill 5958 passed the House last week, 90-5, after passing the Senate in slightly different form. It has been sent back to the Senate for concurrence and is expected to go to Gov. Christine Gregoire for her signature.

Under the bill, doctors offering concierge care would have to inform patients what services they provide and that they don't take insurance. They would have to refund fees if they stop seeing a patient.

The doctors would be barred from raising prices more than once a year, but there would be no limit on how high they could raise them. The bill also warns doctors not to cherry-pick healthier patients, but only by saying that doctors can't reject patients "solely" because of health status.

The bill specifies no penalties for violating its provisions. Instead, that would be addressed by the state Medical Quality Assurance Commission under existing "unprofessional conduct" codes.

The insurance commissioner's office would be directed to analyze the effects of concierge practices on overall patient access, health-insurance premiums and patient demographics, and report back to lawmakers in five years.