If I am Sick, I go to My Insurance Company
I am pondering a conversation with a doctor/friend (unnamed) about the business of medical professional practice...she wants desparately to deliver good health care to her patients, but unfortunately doesn't work for her patients. She works for several insurance companies. It is true:
- She can prescribe a medication that she feels best suited to address an illness and have that decision over-ridden by an insurance company, 'That drug is too expensive, we won't cover that at the same level we cover a (supposedly) generic equivalent'...the patient is forced to trust the company rather than the doctor..and/or pay more
- She runs a risk/threat of higher premiums every time she makes a decision involving surgery...even minor surgery. Every patient pays more, indirectly, for those premiums.
- She pays a full time staff of two whose sole job is to deal with the paperwork and headaches generated by the insurance companies...none of that expense improves the quality of delivvered medical services...and the patient pays for that staff.
- She has patients who have to wait until a new premium cycle begins to re-visit her because of restrictions in insurance coverage...time that can result in worsening conditions, and the patient pays in poorer health
- If a patient wants to pay cash for services, she cannot tell that patient what the costs will be without referring to insurance regulations/requirements/contracts first.
- She plays a constant balancing act with testing labs...too few tests and malpractice liability exposure increases, too many tests and the insurance company may deny/delay claim payments. The patient pays more either way.
In the meantime, if I need to have a physical exam, my doctor tells me that my insurance will cover it and it will only be six months before the earliest possible scheduled appointment...and I count myself 'blessed' to have medical insurance that I can afford.
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