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Health Insurances Force Physicians to Play Games

Daniel Paull MD spells out what he calls the "silly math" of health insurance.

May 16, 2023

Health insurance premiums go up every year, as does your deductible.

What this means is that both you and your employer pay more every year to have health insurance, only for you to have to pay more in order to use it.

The math is actually quite silly.

If you have an 8K deductible, and your premiums cost ~2K per month, that is almost $30,000 a year that you would need to pay, before health insurance covers that first dollar.

This isn’t even factoring in the copays and deductibles that you will also have to pay at the same time.

 

“The math is actually quite silly.”

 

Speaking of that first dollar, if you happen to be out of network, the insurance companies won’t even pay it.

Or if your health event happens towards the end of the year, your deductible can reset, forcing you to pay it all over again.

On the other side of the coin, they are running your physicians, and their practices, ragged.

 

Insurance companies are running your physicians, and their practices, ragged. Click To Tweet

 

They regularly don’t pay, and force physicians to play games in order to get paid.

These games are expensive and have created the system that we have now with high volume practices with little time for actual patient care.

Remind me again how health insurance isn’t a scam?

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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One Response

  1. I’ve enjoyed your last couple articles, Daniel. We have a lot of feelings and frustrations in common, and I think it’s important to air some of this dirty laundry in an ethical way to bring attention to these examples of runaway corporate greed. The silliness/scam continues, in part, because the consumers remain largely unaware. Kudos to you.

    I understand you’re an orthopedic surgeon. I imagine that’s a tough field in which to disentangle yourself from third party payers. It’s hard to argue that orthopedic procedures are not, on the whole, relatively highly valued by CMS and, thus, private insurers. Do you continue to accept most/all insurance plans? Why or why not?

    Thanks for doing your part!

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