It often happens that a patient will come in just before their insurance expires and want me to “order every test”. similarly, they will come after being started on new insurance and me to “do everything” because they are now covered. Despite the sky-rocketing costs of healthcare, there exists much consumerism in healthcare.
In the age of defensive medicine, many tests are performed just to protect our liability. But when you add on the costs of this consumerism, costs become unaffordable for the system.
Patients need to keep in mind who is really paying for the “everything” test. Sure the EOB will show what the insurance paid. But, where does the insurance company receive that money to pay the costs? From the patients either directly or indirectly. Many patients now pay their own premiums while many employers pay for others. When unnecessary tests are executed, the costs to the insurance company rises. And then these costs will return to the patients in terms or higher premiums and deductibles.
If an employer pays the premium, they will be forced to pay more. While this may not directly come out of a patients pocket, many employers cannot afford to give health insurance coverage. Many are offering the insurance but requiring the employees to pay a part themselves. Also, employers can take these increased costs out of other benefits, such as retirement savings.
The patients who come in requesting the “everything” work-up expect the costs falls to the insurers. They are simply wrong here because one way or another, the costs will return to them.
Healthcare spending spiraled out of control. We all need to work to bring these costs down ago. A major conduit for doing so is eliminating unnecessary tests. The insurance companies try to do this by requiring prior-authorizations on certain tests. But, this process has gotten out of hand as well. As a doctor, I am finding it increasingly impossible to get certain diagnostic tests approved, even the ones I feel are vital to my patients’ health. Insurance company employees should not be determining what is medically necessary for my patients. That should be a decision between myself and my patients.
Many people are curious to know their blood type and ask the test to be done. Most of the time it is not medically necessary. I have no problem ordering the test. But, I let the patient know the lab will bill them if the insurance company deems it unnecessary, as I assure them they most likely will. Many chose not to do the test if they have to pay themselves.
Consumerism in medical care is especially damaging because third parties are paying the bills. When the costs rise, they cut down on services they offer. And patients who truly need diagnostic tests for underlying medical issues are often denies. Thus, consumerism is also diverting medical resources away from those who truly need it.
The US possesses the best healthcare in the world. We are the leaders and innovators. Yet, many patients suffer because they cannot afford. We need to put an end to the consumption of medical services when it is not clearly needed. Otherwise, the future of affordable healthcare will be obliterated.
Copyright secured by Digiprove © 2015 Linda Girgis, MD, FAAFP
