I believe in capitalism and I believe that a company shouldn’t be ashamed of trying to make a profit. After all, staying in business is the name of the game. But when it comes to your healthcare, there is some unwritten rule or maybe it is written in the form of the Hippocratic Oath, that entities involved in healthcare should care about your wellbeing in addition to caring about making money.
However, insurance companies really don’t care. They don’t care about you. They don’t care about me. Their entire business model is built on the idea that you pay them a monthly premium and they do everything in their power not to pay any benefits. Their profit margin is realized by how little they pay out for the services you expressly paid them to provide, to restore your health in time of illness.
That means more of the costs are shifted to you in the form of out-of-pocket costs and deductibles. This also means that the hospital and doctor have to accept less payment for the services they provide, but since the hospital and doctor do care on some level, you will ultimately receive the care you need.
The power and monopoly of the health insurance industry needs to be mitigated. As big as they are, and even bigger now with the Affordable Care Act’s dependance on the health insurance industry implementing the 2010 act, there’s only one other industry that can enter the health insurance market, restore competition and our rights as consumers. I’m speaking of hospitals and the health systems they’re apart of. Let me explain.
There’s nothing magical about what a health insurance company does. You pay into a pool of money that they oversee and they pay out those funds, or not, to the doctor and healthcare facilities you utilize. They provide no other service other than to keep as much of your dollars as possible. A hospital or health system on the other hand, does provide you with a service. No matter how cynical you may be, doctors, nurses, hospitals and their affiliated health systems want you to feel better. That’s what they do. Sure they make money in the process, but you want them to make money so they can keep the hospital clean, successfully navigate the myriad regulations placed upon them and stay abreast of the latest in technology you expect from an American hospital.
If the hospital and health system entered the same market as your traditional health insurance company, that would create competition. Competition lowers prices and gives us more choices. They would fight to get more members by lowering premiums and lowering deductibles. And in a way the health insurance company can’t improve quality of care, the hospital will be incentivized to keep costs low so they can improve their profit margin but at the same time, provide the care they’re committed to providing.
You see, at the end of the day, no matter how greedy you think the doctors or hospitals may be, they are the ones there to help you when you’re sick. They keep the lights on in the ER. They return your calls in the middle of the night. The insurance company is nowhere to be found. As I said in the beginning, there’s nothing wrong with a healthcare entity wanting to make money, but doing so without providing a caring service, well, that just won’t do. That’s why we’ll all benefit from hospitals entering the traditional health insurance marketplace.
Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.
