Op-Ed: How can we save our healthcare system?
The health insurance industry used to work well before the age of bonuses and billionaires. Now that everyone wants to have a private jet and a home in the Hamptons, many top CEOs are finding the fastest path to being featured in Forbes magazine is by transferring wealth from the middle class. All the current trends point to health insurance premiums going up while doctors are getting paid less. No matter how you slice it, the common denominator stems from a culture of greed.
Currently most doctors practice in traditional models where they contract with private and public insurance companies, and reimbursement rates are difficult to negotiate. Insurance companies are paying doctors less in the name of saving money. But, how much more can we squeeze out of physicians? It is generally understood that physician salaries are only about 10% of all healthcare expenditures. Let’s face it, the real bulk of healthcare dollars are spent on hospital systems, pharmaceutical companies and insurance company bureaucracies.
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Most people don’t understand how important it is that insurance companies pay doctors a reasonable rate. The rate determines how much time is allowed a physician to interact with a patient. When reimbursement rates are low, doctors will have to see more patients to cover the cost. This is what leads to burn-out and overall poor satisfaction in their job. The last thing a sick patient needs is an overworked, burned-out physician making important life or death medical decisions.
Insurance companies, in my opinion, have also lost their respect for physicians. Healthcare executives would rather talk to a group of health policy professionals with no clinical experience than talk to physicians about keeping costs down. I recently tried to contact my local insurance company representatives as a physician taking care of patients they insure and I felt the cold shoulder.
Solutions to these various problems are complex. Potentially doctors could advocate for new legislation to force government and private insurers to preserve doctors’ rights. But, in reality, legislation cannot change sentiments and budgets could not handle new spending measures. Any forced action against insurance companies will only lead to further insurance premium increases, in order to protect sacred executive salaries.
I believe the true solution to this problem is empowerment of doctors to take back healthcare. To think up new healthcare delivery models that people are willing to pay for. Currently, we have all these clinics and hospitals that cater to a broken insurance billing system. For example, most doctors fill their offices with routine follow-up visits scheduled months in advance because insurance companies do not pay doctors significantly more to take care of acutely sick patients. So, when patients are sick they are quickly dumped into overburdened emergency rooms. The system wants to blame doctors for providing poor services or underestimating the satisfaction of their patients, but the reality is that doctors that work in an insurance based system are forced into this mess.
It is time for doctors to rise to the challenge and take back healthcare. They need to innovate new payment structures for patients outside of the constraints of health insurance. This will help doctors provide their medical expertise, while making competitive changes to the way healthcare is delivered. In my opinion, this is the only way that we can save the healthcare system and naturally bring payers back to reality.
The writer is affiliated with Urgent 9 Urgent Care Center in Glendale.