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What Physicians Know (Guest Voice)

What Physicians Know

by Joel S. Hirschhorn

I had a long conversation with my favorite physician, who has operated on me twice successfully. He is an incredibly kind person without an ounce of greed or pretense. Like other physicians I have spoken to, he spoke eloquently about the terrible times he consistently has with private health insurance companies.

While he praises Medicare for its simplicity and certainty, he has absolutely nothing positive to say about private insurers. They take up huge amounts of time of him and his staff, trying in every possible way to deny services to their customers (his patients) and also to pay as little as possible to him. His endless struggles with the insurance companies make his life miserable. Meanwhile all he cares about is giving his patients the very best care and not making them suffer because of their insurance carriers.

Like so many of us he sees the need for major reforms of our health care system, but remains pessimistic about what Congress and President Obama will eventually deliver. He is incredulous at how executives of private insurers make vast amounts of money while making physicians and their patients suffer endless annoyances and negative impacts on health care. And they get away with making people pay more and more money for worse and worse insurance.

He also has many stories about patients that do not take medications for long term chronic conditions because they cannot afford prescriptions. He gives out as many samples that he can get, is angry that people in other nations pay much less for brand name drugs, and feels terrible for his patients because the US health care system has let them down.

What would be the ideal solution to the current health care mess?

My doctor believes that opening up Medicare to everyone would be wonderful, and the system could be opened up immediately. I totally agree.

There is no sound reason for Congress to protect the private health insurance industry. But of course they always have and always will because it is the source of huge amounts of money for political campaigns.

While no one should be forced into Medicare, just making it available to all who want it would be fair. If private colleges compete with public ones, and private for profit hospitals compete with nonprofit ones, why shouldn’t health insurance companies be put in a similar position?

Corruption blocks true and necessary health care reform. Remember that the next time you vote.

Joel Hirschhorn is the author of Delusional Democracy. He is not a fan of either party.

  • sparkles43
    "There is no sound reason for Congress to protect the private health insurance industry. But of course they always have and always will because it is the source of huge amounts of money for political campaigns."

    This is exactly the problem. And these politicians are not serving the people, but themselves.
  • JSpencer
    Yup, that's the elephant in the room allright, and some folks are fine with the elephant, they just pretend they don't see it.
  • dduck12
    One physician's opinion. Ask a few more and make some of them Reps.
  • DaGoat
    One physician's opinion.

    Exactly. The left is really pushing this "Physicians Love Medicare" meme.

    In my career I've talked to several hundred physicians and most of them would not support Medicare for all. Medicare pays less than private insurers (in most areas anyway) and the paperwork is no less burdensome. The one area they are easier to work with is in not requiring pre-authorization of testing and procedures, but this is actually an area they need to improve on since their current lack of oversight invites waste.

    I can only assume the doctor in the above article never had to fill out Medicare forms for diabetic testing, diabetic shoes, home oxygen, wheelchairs, scooters, etc, etc.

    If you ask 10 physicians in my city whether they prefer BC/BS or Medicare, at least 9 will say BC/BS.
  • dduck12
    Interesting. Hope you aren't seeing them for medical reasons. Medicare is definitely in trouble and easy prey for fraud (60-minutes, two weeks ago), it needs major surgery and should have been fixed in previous admins, and this one one too. And forms: everyone hates them and yes some insurers hide behind them and look for ways to deny or delay claims. There are no white hats, black hats, in this health care area, it is a Gordian Knot, and neither party admits it.
  • "There is no sound reason for Congress to protect the private health insurance industry."

    No, of course they don't need to be protected, but that's not the issue. The issue is whether the government should compete against them and pass legislation designed to punish them. Insurance company profits are a convenient scape-goat that allows politicians to ignore the real diverse and complex cost-drivers that can't be explained in nice sound-bites. I don't like the public option, but I actually agree with the President that it should not be the center of the debate. What I don't like even more is that all the debate over the public option and the evil insurance companies has pushed out real debate over how to control costs.

    I'm not going to cry for the health insurance companies if they go under, but I will cry if we do all of this reform and find that we haven't succeeded at controlling costs. It will be decades more before any consensus is reached about whether the current reforms have worked and enough political momentum is built up for another change. You can't control costs just by setting the price lower. If you do that and don't address the fundamental supply/demand issues you will create more problems than you will solve.
  • dduck12
    Well said.
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