Recently, my television screen has been filled with pictures of angry protestors, standing up against health care reform imposed by the federal government. Prominent among the statements was a single refrain: "I want my doctor."
Sorry, but perhaps you haven't noticed. The people who took your doctor away were not monstrous federal officials, but health insurance company executives. They did that by selling health insurance plans to a company, then jacking up the premiums so that the company (whose employees had become a few years older and a greater insurance risk) would find another company. Each company had its own contracted doctors in its network and when employers moved from one company to the next, they lost "my doctor" and replaced him or her with a new "my doctor." The demoralizing effect on physicians was severe, as physicians came to realize that they were merely pawns in the insurance game, that the patient who sang their praises on December 31 would be moving to another doctor on January 1st, and that the historic physician-patient relationship no longer existed. And those health insurance companies did something else: they negotiated rates of payment to the doctors which were actually less than the Medicare rates of payment, leading the most qualified doctors who provided high quality care, to drop out of some of the plans, retire or leave town, so that you couldn't see "my doctor" under any of the plans provided by the health insurers and your employers. Or of you did get to see "my doctor" it was not to spend the 15 or 20 minutes with you as was the doctor's customary practice, it was a 5 minute visit because that was what the health insurer, financed by you and your employer, was paying for. You may have also noticed that some of the new doctors in the network provided by your health care insurer and your employer weren't quite as well trained or qualified as your old "my doctor" who you couldn't see any more. Lots of reasons for that but you can imagine most of them.
So let's do away with the mythology that the big ugly federal givernment bureaucrat is taking away "my doctor." That was done by health insurers, your employers, your unions and you. Sorry.
Subscribe to:
Post Comments (Atom)
Posts
1 comment:
As I see it, the federal government may well replicate all the nasty insurance company things. Medicare already limits the number of doctors via the reimbursement scheme. The "I want my doctor issue" is not resolved by either the current insurance company controlled scheme or a future government controlled scheme. I recall some years ago that the feds [Ted Kennedy I think] wanted to "break up Microsoft". I was quite torn between picking Teddy or Bill Gates as "Computing Czar". In this case the marketplace has begun to reign in Microsoft. I draw no particular lesson from this. --LCB--
Post a Comment