The Health Insurance Business is Rigged Against Consumers

Recently, a physician wrote an Op-Ed piece for the New York Times in which he revealed how doctors get better treatment from the health care and health insurance system than you or I do.  He recognized that the health insurance business makes as much money as it does from us by raising as many barriers as it can to prevent us from getting health care.  The industry claims that it does this only to make sure that we really need the care in question but anyone who has spent days on the phone or going from doctor’s office to doctor’s office trying to get the necessary permission senses intuitively that this is a scam.  The barriers are there to frustrate patients to the point that they finally give up and either don’t get the care or get it but end up paying for it themselves.  The author’s basic point is that our health care insurance system is so broken that only by “pulling rank” can you get what you believe you paid for in the first place.

One of the ways in which health insurers make money is to insist that the patient’s doctor convince the insurance company’s doctor that the care is necessary.  This would be a significant barrier under the best of circumstances but is made even worse when, as is sometimes the case, the insurance company’s doctor has no expertise in the area in question.  It is also significant that the insurance company keeps track of how often and how quickly its doctor approves the requested care.  Too many approvals often mean that the insurance company goes looking for someone else who may not be quite so sympathetic to the needs of the patient.   Doctor patients can get a break here.  When the insurance company requires that the patient’s doctor call the insurance company doctor, doctor patients sometimes make that call themselves.  When they do, they are often given special consideration by the insurance company doctor.

Large deductibles can be a great burden on patients.  While doctors usually have the money to pay these deductibles when they are patients, they get a break here as well. Treating doctors will often waive deductible amounts or otherwise reduce their bills for patients who are themselves doctors.

Although they cry doom and gloom, insurance companies have been making out like the bandits they are during the Obama presidency.  Since 2009, the price of stock in Aetna, a leading health insurer, has increased over 600%.  And Aetna is a poor performer compared to its fellow insurers.  WellCare has seen its stock price increase by over 1,400%.

The bottom line is to cry not for the health insurance companies.  Cry instead for the poor consumer who is being ripped off to support these increases in health insurance company profits.

Posted in Doctors, Health Care Costs, Health Insurers, Medical Costs |