Can doctors lead the fix?

America’s health care system much like Congress, it is broken and doctors must be part of the solution. I don’t know a single doctor who doesn’t want to improve our ability to increase access and delivery of health services for our patients. Save and/or improving the health of patients is our goal. This should be the goal of anyone associated with health care system, but it is not Currently, our system is infiltrated and plagued by profit. There is no quick fix or cure. I have ideas for how to make improvements but let me point out what I see as the biggest problems.

Doctors Economic structure

America’s capitalist economy works well for many industries, but not all, and health care is not one of them. Health care is often not subject to the same standards of supply and demand and, therefore, cannot be considered a standard market. Insurance companies limit your choices when they force you to see someone “in network,” so your ability to choose the doctor you want is already limited, if not eliminated. When your family member is sick, the typical response is to do everything you can to make him or her better. When this is an emergency situation, you don’t stop and shop around for the best provider or the cheapest deal. And despite what most people think, it’s actually against the law to turn away an emergency patient for lack of insurance. it IS partly, why community hospitals can’t stay open anymore. Such hospitals must compete with the sometimes for-profit facilities next door – which usurp all the well-insured patients.

hospital I DO the budget for the care of the poor, which is reimbursed by the government (you and me). Similarly, all those patients who cannot afford treatment for their chronic medical conditions, who present in crisis in the ER with severe consequences of this neglect, will receive the services they need that they cannot. afford them. So when you think about it, providing that CoRe the level health care to such patients is Actually economically smarter option. And clearly IS more humane and ethically appropriate SOMETHING to help prevent such morbidity where possible.

Doctors: The great players

I would like to think that doctors are one of the biggest players. But as doctors, we know better, Doctors were considered the pillars of society. And sometimes, they still are. But often,health careproviders areFREQUENTLY mistreated and blamed for our current situation.Patients are attacking doctors’ offices and hospitals. Society has demonized doctors and in a handful of cases, rightfully so. There are some bad doctors out there who got into medicine for the money. Or others who are now disillusioned with the practice and offer reimbursement-based care as opposed to standard of care. Those bad apples are tarnishing the entire profession. But this is it only they are bad apples among the bunch. Please know that most doctors really I want to help get you and keep you healthy.

Doctors salaries

Suffice it to say that doctors’ salaries make up a minimal component of the total health care spending at only 8.6% in 2011. And this was the second lowest among Western countries with a “modern” health care system. More than a decade later, doctors’ salaries remain stagnant IN 8.6% of health care expenditures. What mostpeople don’t know him IS that for the last 20 years, we have been paid a little less every year for the same services. What other industry is paying the least?every year for providing the same services? And it’s just the doctorsothershealth careplayers have been more and more for the sameTime period. it explains why doctors now have to see more patients than beforeonly to earn the same amount and cover expenses, while the latter increase every year.And you can’t pay your staff less every yeargrowth of overhead and personnel comes out of the doctor’s salary.The medical assistant (MA) can now make more at Buc-ee’s or Costco than we can afford to pay them to work in our office.

If doctors’ salaries aren’t the problem, what is? Let’s start with the biggest player: insurance companies. It is in the interest of insurance companies to deny coverage and care as often as possible. It is expensive to keep you healthy. But it is even more dear to try to treat you when you are sick. When we make being healthy a priority (preventive care), in the long run, we all do better. But health care companies are in it for the bottom linethat is here and now. Denying coverage for things that practicing doctors have ordered is the norm. Prior authorizations have become such a nuisance that we are making state laws to help deal with this. Texas led the way with the golden card bill, which sought to exempt physicians with prior authorization approval rates of more than 90% from having to obtain prior authorizations.

Obamacare

Similarly, the Affordable Health Care Act (ACA), otherwise known as “Obamacare,” implemented the 80/20 rule, which stated that 80% of the premiums collected had to to be spent on medical claims.itwas to reduce insurance company profits and hopefully lower premiums.My family and I received a check from my insurance companythat next year for more than $500. But no wonder, we never got another check because the insurance companies implemented the right solutions, driving up the costs of medical claims.SoTHESElawend up havingbig goals but withabsolutelyno practical impact.

Affordable Health Care Act (ACA)

While insurance companies blamed the ACA rate hikes (which is technically correct since it was theirOWN reaction to the 80/20 rule), they were still able to raise their CEOs’ pay. The combined CEO pay of the eight largest publicly traded insurance companies, including CVS Pharmacy, which bought insurer Aetnawas $143.5 million in 2017, up 14.4% from a year earlier. As of 2023, the highest paid insurance CEO earned over $22 million.

The other big player is drug companies. While drug companies are paying tens of millions of their CEOs, most Americans can’t afford their prescriptions. In 2022, the top 10 CEOs of pharmaceutical companies earned $28 million a year or more, with the highest paid receiving more than $124.9 million a year. Thank God for Mark Cuban, Alexander Oshmyansky and Cost Plus Drugs. Even though they are a profit seeking companyso thatstay in business, that isCLEAR not their motivation.MISSIONit is clearly statedon their website: “We will provide the consumer with low-cost, high-quality pharmaceuticals by any means possible.” As Mark Cuban says, “I could make a fortune out of this, but I won’t. I have enough money. I would prefer to freeze the drug industry in any way possible.“ Why can’t the government do this? Because the politicians are in the pockets of the big players.