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The Downfall of Medicine: Corporate Health Care and Insurance Game

The highest quality lowest cost care will be found between an independent healer & a patient with direct transparent prices and payments. No middlemen allowed. If the Patients and Healers Stand Together, the Game is Over.

July 22, 2021

The current health care ecosystem is a perverse game that hospitals, insurance companies and politicians are playing with the financial and medical health of Americans everywhere. At the end of the day, we are all patients. Your healers have sacrificed decades of their lives and mountains of debt in the hopes that they can serve you the patient. In hopes that they can somehow make your life better.

Unfortunately, big business and the government has corrupted the system with perverse incentives. In the traditional system, healers are fighting shrinking compensation and rising costs on a year after year basis forcing many of them to sell out and become employees to large corporations. Upwards of 70% of physicians are now owned and controlled by hospitals, insurance companies, and other large corporations like private investment groups. These organizations did not swear the Hippocratic Oath to “Do No Harm” and they place patients in a secondary position as byproducts of their business model. Business models that are geared first and foremost by profit.

 

Your healers have sacrificed decades of their lives and mountains of debt in the hopes that they can serve you the patient. In hopes that they can somehow make your life better. Click To Tweet

 

 

Hence why there are now 5 health systems, 7 insurance companies, and 14 pharmaceutical companies in the Fortune 500 list when 40 years ago there were few to none.

These companies are in business to make their executives rich and profits for their shareholders, not in the business of providing the highest quality lowest cost care on the market to patients. In fact, over an 8-year period from 2010 to 2018 the top 5 insurance companies, commonly referred to collectively as “the BUCAHs”, stock prices have skyrocketed from 526-911%. Furthermore, HCA CEO Sam Hazen made $30.4 million salary in 2020, which is 556 times the average HCA employee, in a year when HCA employees were forced into wage freezes and or threatened with furloughs or layoffs.

These businesses have now become vertically integrated to the point that United Health care subsidiary Optum Care is also now the largest owner of Physicians, at just shy of 60,000.

When physicians are no longer independent small business practices they are controlled, abused, and silenced by their corporate owners. Often having to settle for decreased quality of service or care due to factors that the corporation will not improve or change.

Many times, if healers do advocate on behalf of better service and care they are internally punished at best or fired at worst. Furthermore, these big businesses continue to exert control at the state and federal level by lobbying with BIG money to politicians in exchange for favorable rules to be continued or written into law which allow them to continue making massive profits year after year, even at the detriment of patients and healers. In 2020 alone hospitals, pharmaceutical companies, and insurance companies lobbied with 650 million dollars to politicians.

 

Many times, if healers do advocate on behalf of better service and care they are internally punished at best or fired at worst. Click To Tweet

 

 

Patients and Healers have become “cogs in a wheel” to profiteering middlemen that reap most of the monetary benefit and provide little to no value to patients. Patients are charged inflated prices for health care from both hospitals and insurance companies.

In a hospital setting labs, imaging, and medications are often marked up hundreds of percentage points over typical market prices. Insurance companies have raised premiums on an annual basis and include so many mechanisms to charge patients even more not limited to copays, deductibles, co-insurance, and claims adjudication while often denying, delaying, or refusing care. According to the Kaiser Family Foundation in 2020 the average family of 4 was paying $21,342 in premiums alone.

Finally, there is a large deficit in financial education in our country which is even worse when you consider medical care financial education. This is compounded by the lack of transparency in pricing, the complexity of medical billing, and the obfuscating of honest customer service. An all too common example of this is as a patient when you call a local hospital system or doctor’s office and cannot even get an upfront transparent price from the representative on the other end of the phone.

 

 

They simply tell you “We don’t know.” Unfortunately, this response is not completely untrue as a recent Wall Street Journal article highlighted. In this case at the same hospital in California you could be charge $6000 or $60,000 for the same cesarean section surgery depending on the flavor of insurance card you presented.

The stark reality is that lack of transparency in pricing and many profiteering middlemen standing between the patients and the healers are fostering most of the problem. When patients don’t know the transparent price of the bill it’s very easy for inflated prices to be charged and for middlemen to pull profits from the system.

 

The stark reality is that lack of transparency in pricing and many profiteering middlemen standing between the patients and the healers are fostering most of the problem. Click To Tweet

 

 

Complexity of billing, lack of transparency, and profiteering middlemen like pharmacy benefits managers and group purchasing organizations (often which are subsidiaries of the larger health corporations we discussed above) all lead to inflated prices and massive profits. Unfortunately, this also leads to the state of the current system where customer service, accountability, responsibility, and care are marginalized in pursuit of profit and patients and healers are harmed in the process. Unfortunately, we are not only talking harm in terms of health. We are also talking harm in terms of wealth as 500,000+ Americans go bankrupt every year in part or wholly due to medical bills, most of them with health insurance. A recent New York Times article suggested that in total Americans have $140 billion in medical debt.

The highest quality lowest cost care will be found between an independent healer & a patient with direct transparent prices and payments. No middlemen allowed. If the Patients and Healers Stand Together, the Game is Over.

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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