When I was a kid, healthcare was simple and relatively inexpensive. I would go to the doctor and the doctor would take care of my ailment. The doctor’s office would bill the insurance, who would pay 80% of the bill and my parents would pay 20%, and we were done.
Fast forward to today, and the question is, what happened? The answer is, follow the money. People realized that there was a lot of money in this healthcare industry. The insurance companies wanted more, but so did the government, and so many others. Healthcare is a powerful way to control people and their money.
So businesses formed and inserted themselves between people and their doctors to make money. The legislators had to find things to regulate and paperwork to be filled out by doctors, requiring doctors to hire and pay more staff to comply with all the new paperwork regulations. The amount of administrative fees it costs your physician to fill out all of the paperwork required for your office visit equates to 8-10% of the money they would have received. Your costs rose.
IPA’s (Independent Physicians Associations) formed an administrative level between people and their doctors. More money.
HMO’s(Health Management Organizations) formed, to provide healthcare that enlists a group of physicians who will perform services for the members who pay a fee monthly for membership. Each HMO sets the rules of care they will cover, and the doctor must work within the guidelines set by each different organization, and accept the pay, generally a monthly fee for members, not for services rendered. The more services and tests they give, the less they make.
This is not in the best interest of the patients, but of the bottom line. The doctors have so many hands in the pie of their income, and so much administrative expense, preventative legal costs, and reduction of pay for services rendered, that they are upside down.
The insurers determine what procedures will be covered. If you have been getting an injection for your knee that works for you, but your insurer decides that procedure has a percentage of people that do not benefit, they can just refuse to cover that injection.
Plans like Kaiser have a model wherein they assign contracts to people that are not sick (same premise with Obamacare), and restrict access and benefits to those who are sick. You can still be taken care of, but procedures and medications that are covered are more restricted. This way, costs stay down.
Deductibles have become so high that most people are effectively paying out of their pocket, in addition to paying exorbitant insurance rates, and getting no benefit from insurance at all. Those who do have catastrophic or long term costly medical needs will see a portion of their bills covered, with exclusions to services and medications the individual insurer has deemed appropriate for you.
Many people who now are faced with $5000-$6000 deductibles, either do not go to the doctor, or just do not pay the bill at all. This further devastates the doctors and hospitals, who have given the services. All of this is to the benefit, not the detriment of the insurers. They collect their money either way.
Doctors are finding it no longer practical and profitable to go into private practice, so most graduating doctors today are going into the managed health organizations.
All of this has made our healthcare bad for us. There is no personal relationship with your care provider. It is cheaper for the doctor to have Physicians assistants or nurses (extenders) see patients. Doctors would have to see 25 or more patients a day to make less money than they used to, and that is just physically impossible.
We have no patient doctor relationship. Doctors cannot make the income they deserve for the work they do and the education they have. Administration costs are so high, layers are too deep, and strangers are determining our healthcare, literally telling us what we can and cannot have for our own personal health.
We are headed to single payer care, which I think is a tragedy for all Americans. How did all these businesses, layers, legislators come between us and our doctor? The Nazis knew that if you control people’s health, you control people. Follow the money and think about who is profiting from all of these regulations and layers of administration. I am so insulted that people sit in a remote building, look at a screen and decide what procedure I can receive from my doctor. This is our lives people. I want my doctor/patient relationship back, with no one between us. We need to wake up America, and fix this before it is too late.