Membership fee-based medical practices are proving to be an attractive option for patients and families that are uninsured, according to an article just published in the Chicago Tribune. Such practices don’t take insurance at all, but charge their “members” a monthly fee for unlimited office visits, some related services, and discounts on medications and lab tests. At MedLogic, one practice cited in the article as an example, that fee is roughly $140 a month. Fees vary based on the practice, the number and age of family members, and other factors. Proponents of membership medicine say clinicians have more time face-to-face with patients than those driven by insurance fees; physicians tend to see fewer patients over the course of a day, as well. Critics charge that patients end up paying for more care than they receive, and speculate that if the idea catches on the existing shortage of primary care physicians could get worse. It’s likely that the cost of traditional insurance plans would go up if membership rolls shrink, as well. In Illinois, the Department of Insurance does not consider direct primary care practices to be insurance. Federal tax law, however, treats direct primary care practices as health plans, so patients cannot use health savings accounts to pay membership fees without incurring a penalty. Some urgent care operators are trying the concept out, too. Range Urgent Care, for one, charges members $30 a month and then $10 per visit, during which they can get x-rays, certain procedures, in-house lab work and prescriptions, and most treatment typical of the urgent care setting (eg, for broken bones or lacerations, and school physicals that cost nonmembers $25).