What's so great about having a choice in health insurance? The more I think about this, the more reasonable a government run national health insurance plan like Medicare seems. Don't get me wrong. I'm a diehard conservative who's watched his fair share of Fox news and grew up in Limbaugh country. What I don't understand is why many physicians are so upset over the thought of the Feds offering a public option if not outright taking over the health insurance industry.
We physicians have been complaining about the insurance industry for years. They arbitrarily deny reimbursement for procedures performed due to some asinine paper work technicality. They deny approval of recommended treatments, usually from some minimally trained clerk taught in the art of denials. The overhead of office staff just to fill out insurance forms and calling for approvals is wasteful. The insurance companies pay their executives millions of dollars a year while scrimping on reimbursements in order to maximize shareholder returns.
As users of health insurance know, the policy holders also lose out. We pay thousands of dollars a year for insurance but the instant we use it, the premiums go up. There are well documented cases of insurance companies cancelling policies after a policy holder gets sick. If you've ever gotten a prescription from a doctor, you may be denied health insurance in the future. Insurance companies have left policy holders destitute after cancelling policies during the middle of expensive medical treatments.
By comparison, Medicare is available to everyone, with the only eligibility criteria being age and citizenship. Sure Medicare reimbursement fees would be laughable if it wasn't so low, especially for anesthesia, but at least the government pays. In a field like anesthesiology, the reimbursement from patients with private insurance can be perilous. Patients ask the surgeon if their insurance will cover the procedure but maybe don't think to ask the anesthesiologist. If the anesthesiologist doesn't take the same insurance, the patient is on the hook for hundreds if not thousands of dollars in anesthesia fees. Thus the anesthesiologist frequently doesn't get paid at all.
Think of the savings in overhead if there is only one insurance company to deal with, Medicare. No more wasted staff time filling out dozens of different insurance forms and calling different companies. That savings alone in time and money could almost replace the lower reimbursements. Also no more headache of telling an anxious and sick patient he cannot be treated because his insurance company has denied the procedure.
There's a reason many of the protesters at these town hall meetings are the elderly. They love Medicare. They don't want any changes to it. It gives them the freedom to see any doctor they want, anywhere they want, whether it's in Florida, New York, or Boise Idaho. They don't have to deal with insurance representatives and their unhelpful call centers. Do physicians give different treatments to patients just because they have Medicare? No. We offer the best treatment based on scientific principles, not insurance status. So where is this fear of rationing under Medicare?
So I think doctors' reflexive dislike of a public option for health insurance is misguided. How can we justify a for-profit industry that interferes with how we treat our patients? Under the Hippocratic oath we are supposed to do no harm. But when the industry denies treatments and forces doctors to drop their patients because the patient no longer has insurance, isn't this harming the patient? It is time we rethink our self-serving dislike of Medicare and think about the greater public good. As far as the costs, I've mentioned before that perhaps the U.S. needs to spend a lot more on health care. Until we can change the prevalent attitude that it is abhorrent to place a price tag on a human life in this country, everybody is just going to have to keep shelling out more money but that is a whole different subject.
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