Money is easy. Consumers feel they pay too much for too little insurance coverage, insurers want profit, physicians and other providers want salary and the government wants to throw enough money at the problem for someone else to take care of the management of the mess that is our health services industry. Keep it simple today and recall that affordability is only one prong of our requirements, we also require accessibility and quality in our health services.
Today, speak about issues with one of those other prongs. Will money alone fix the strong-arming recently used by physicians and their lobby to obtain legislated pay increases and incentives when they participate in Medicare? Those threats were used to maintain current levels of physicians accepting new Medicare patients. What will stop these "healers" from going back to the till again and again to request more money for the same level of services they provide today? The answer is nothing. Today we need physicians to change their approach and return to their code of ethics instead of arguing that they'll do the same stuff for more money. The biggest pitfall of this approach is that the temptation to do less stuff for more money has also contributed to the ongoing crisis. Is it right that an insurance company allow physicians to "charge for a service" at a specific rate even when that service is provided by some new form of nurse or physician's assistant? The savings that physicians gain by having someone besides a physician perform these tasks should have been passed on to the consumer. Instead, by allowing categorization of a job performed instead of who does it to dictate the rates, charges remained the same or increased. The logic of this approach is non-existent.
We've seen this approach of using someone who gets paid less for doing a specific task motivated by a desire of the person paying to save money. Sometimes those savings are passed onto the consumer as in the case of a choice to use an unlicensed handyman who will charge less and will often be able to perform a task. Other times, the savings are not evident to the consumer. In the case of companies outsourcing work functions to different countries, we hear that they use this tactic as cost containment, but where is that saved money going? Not into the consumer pocket. This is the same argument used to defend hiring criminal illegal immigrants instead of citizens.
If in reality, WHO is performing the work is irrelevant then drugstores and gyms should have kiosks where prescriptions are handed out by non physicians, where stitches are sewn for injuries, and where physicals are given. These services could easily be offered at a cheaper price than individuals currently pay to make an appointment with a physician and never see a physician at all. Money alone will not solve this problem.
As consumers, dealing with our insurers, our providers and our government we must emphasize that more money doesn't fix basic problems with our system. Throwing money at insurers without demanding that a certain percentage of the money they take in from premiums MUST go to paying for medical services for insureds is absurd. Currently less than half of every premium dollar paid by consumers goes for actual medical services.
Our fear...doctors won't take us, health insurers won't accept us, we'll be dropped...has dictated our demands. Just having health insurance is meaningless if it doesn't cover the risk of the cost of illness. Thirty page policies describing exclusions from coverage, exceptions, copays and deductibles do not solve this problem...health insurers are not pulling their weight in terms of covering the risk of the cost of treating illness. Bankruptcies from medical costs tell us this fact.
Keep it simple today and consider that we also need access and quality in our health services.
