Private Insurance Companies & the Center for Medicaid & Medicare currently dictate the healthcare Americans receive. This needs to be abolished and banned. If an American sees their physician and needs a particuar treatment, the insurance company ought not to be able to say no simply because they don’t want to pay for it. This is a massive problem in our Country, from Hospital visits, PCP visit, specialists, hospice, nursing home patients, etc. This goes hand and hand with kickbacks received by medical institutions and physicians for utilizing what the insurance company wants them to use rather than what’s best for the patient and their care needs. Insurance companies are currently buying up many large heath care institutions to take even more control of the care provided to American citizens. This needs to be addressed at the highest level.
This. 22 years ago as a undergraduate surgical research intern, every single surgeon told me to go into another field. Why? Because insurance co’s were dictating their services. Not the needs of the patient, not what they know to be best practice… insurance companies.
The CPT codes used need to be drastically reformed or better yet, abolished.
Look at the preventative services covered: (https://www.ama-assn.org/health-care-advocacy/access-care/preventive-services-coding-guides) like mammography, there is data indicating mammography can be dangerous; Billing and coding have become the ‘controllers’ of health care, a fortune is spent using these codes to bill and to what avail?
Lost my father-in-law to cancer because the insurance company wouldn’t pay for testing as he had only 4/5 symptoms or something stupid like that. Insurance companies need to stop dictating what a person can and cannot do!
Yes…and thier primary (insurance companies) obligation is to make a profit while providing quality care so theycannot serve the shareholders interest and thier customers interest at the same time…of course they are not going to give the best treatment but the most cost effective…we have handed healthcare systems to a for profit entity which is imo definetely not good for the health of our society.
This is THE most important healthcare policy we need. Leave medical decisions to PATIENTS and their DOCTORS.
YES! Health insurance companies have too much authority to dictate what kind of care patients receive. We pay huge amounts to have health insurance, yet, a lot of people put off going to the doctor because they know their health insurance won’t approve medications, procedures, etc. that they actually need. Health care needs to be dictated by qualified doctors that have spent years to learn about medicine and not some entry-level employee sitting in a call center for a giant health insurance company that just reads whatever the computer tells them to do.
I agree. I would add: it should be illegal to allow insurance companies to own (by way of shell companies) hospitals and medical groups/practices.
I work in a primary care physicians office and we spend more time fighting with insurance companies to get prior approval for imaging or medication that the Dr. orders than we do treating our patients. It has gotten insane how much private insurance is controlling how your doctor can treat your medical conditions.
100%!!! I was stuck in a bed for several years because of a herniated disc. Over the course of those years I put on 100 pounds from not being able to move. When I finally got insurance, I got a referral to a surgeon - but I lived in an area where you had to go to the doctors at the insurance’s own clinics… coughKAISERcough… He told me my back hurt because I was fat. He ignored the fact that I had no feeling in my foot and that I had foot drop and shooting pains, and that I told him I put on the weight BECAUSE of my injury.
I went to another town where the insurance didn’t own the doctors and seen a surgeon there. He did the surgery and for 12 years now I haven’t had a lick of back pain… It was ASBOLUTELY surgical.
This definitely needs to happen. Insurance companies should not be making medical decisions when it affects their profits!!!
I agree. As a prescriber, having to work the red tape of prior authorizations and appeals for medications, equipment, etc. takes a lot of effort, energy and time they don’t have. It absolutely dictates the patient’s healthcare. I think this is spurred by a much larger issue with the entire process of our healthcare system and the intermingling of government agencies, pharmaceutical companies, insurance companies, lobbyists, and institutions of higher education.
The amount of times I have gone to the doctor and she has ordered me a medication for a treatment and the insurance company has come back and said, “We don’t think you need this”… excuse me? Where is YOUR doctorate degree? Since when do you know better what I need that my doctor who just saw me and you don’t know me from Adam? Or the amount of PRIOR AUTHORIZATIONS on medications I have taken for almost 10 years. It’s sickening.
Insurance companies have too much power. They dictate not only what medication, imaging, surgeries, and specialists can be seen by patients. They re-imburse providers at different rates. This makes it impossible for a small practice to make ends meat. They set you up to fail. Working for large hospital systems does not lend to good patient care. When you are pushed to see a patient every 15 minutes and hundreds a week to increase $$$, patient care suffers. Critical assessment and information is missed. Patients become sicker while waiting to be seen and then when seen are pushed out the door for the next. Doctors, nurses, and specialist are tired. They waste critical time that can be spent in better assessment, fighting for the needs of their patients. Often times giving in to insurance company and telling patients they cannot have the care they need. We want to help people. We would not have become providers if we did not care. We need help to help people and their health care needs!
Health care professionals and hospitals should have to post their prices along with the prices they contract to pay eaxh insurance company.
Healthcare providing homes should also post all their prices.
This is exactly right!!!
YES I was looking for this one!
No, absolutely not. The primary issue with health insurance right now, and by extension healthcare, is poor policy by the US government. The US government knowingly forced the responsibility for our healthcare coverage into the hands of private, for profit insurance companies and employers. I want the government out of private insurance and out of private healthcare. If the US wants everyone to have healthcare it needs to bite the bullet and force prices down by making themselves an affordable, comprehensive competitor.
Agree. After 30yrs of medical practice I took early retirement. I spent the last 15 yrs fighting insurance companies on what was best for my patients. So many of my colleagues just gave up and let them dictate treatment and medication. The hospital corporations have kept changing and developing policies that appeased the insurance companies, thus undermining patients quality of healthcare.
In addition, owning your own practice became prohibitively expensive as 70-80% of the overhead is dealing with the insurance companies. This put the majority of physicians working for these hospital corporations, who depend on the insurance companies. Healthcare in America is therefor subpar.
I’ll be good if they can get the insurance to QUIT CALLING ME!
Absolutely need to be doctors making medical decisions not insurance companies.