In her home country, everything is free. However, there is a catch — certain services are only available to those who pay for private insurance. Those who are on the “free plan” sometimes must wait months for procedures. My patient said  she knew many people who died on the list waiting for procedures. So, which is better — free rationed care where people may suffer consequences waiting in line or overpriced care that not everyone can afford?

The U.S. leads the world in innovation but prices citizens out of the system.

Many people viewed the Affordable Care Act as a way to end the problem of uninsured patients. Yes, in the U.S., we now have more lives covered by health insurance. However, people are paying for that insurance more than they ever had in the past.

And that insurance does not cover all their medical needs. Many now face high deductibles that they cannot afford. People are skipping healthcare because they cannot pay those high deductibles, despite the fact that are now paying the premiums. Also, many insurance companies greatly narrowed their formularies and coverage for various procedures.

Getting a patient to have an MRI now feels like trying to arrange a meeting with the Queen of England: it simply is not going to happen even if you follow all the right steps. We are left with a system that is inaccessible to many and when a patient steps into the medical arena, they often cannot get the care they need. For those who support the ACA, yes we now have less insured, but clearly the system is more broken than ever before and the middle-class is being squeezed the hardest.

Many people oppose rationing of medical care but that is exactly what we have now. If you do not make money and your only choice to get healthcare insurance is to go on Medicaid, you are eliminated from many choices of medical services. Last week, I tried to refer a patient with severe knee pain to an orthopedist and the nearest one that accepts that patient’s insurance was almost an hour away. This despite the fact that our town and surrounding communities are the location of many orthopedic practices. Several HMO Medicaid plans now cover a limited number of generic medications. Medicaid patients are not offered the same choices of medications or treatments based on their insurance coverage.

Where are we now in the U.S. with the healthcare system?

  • Tax penalties face those who opt out of health insurance coverage
  • The government is spending billions of dollars on the ACA and now most of those politicians know we either need to repeal or reform the law.
  • Insurance companies drop out of the healthcare exchange markets because they are losing money, further limiting patients’ choices

Big Pharma companies fleece patients while driving up healthcare costs to ridiculous levels as witnessed by the recent Epipen fiasco.

Yes, our system is in dire straits with no good plans for reform. But, is a system where patients wait months on a list to get routine care any better? For those patients who died waiting, the answer is clearly no.

In the US, we lead the world in innovation. Yet, many of our citizens are priced out of the system. We need to do better. We need to get rid of political agendas and greedy business men and women at the reins of the system. Who has any ideas for real reform?

© 2016, Linda Girgis MD. All rights reserved.

Digiprove sealCopyright secured by Digiprove © 2016 Linda Girgis, MD, FAAFP

5 thoughts on “The Increasing Unaffordability of Healthcare

  1. Doctors need to stop taking insurance for services (office visits); do we ask All State to pay for our new brakes, or oil change or new tires? Insurance should be for major costs, of tests, major procedures, hospitalization.
    If physicians swear off insurance, including Medicare/medicaid we can unshackle ourselves, with much less regulations (our liability carriers will likely compel other regs on us). This will drastically decrease our overhead leading, ideally, to decreased need to increase volume of patients and presumably more time to the patient which should lead to fewer tests and IMO better care in general.
    WRT Rx costs, similarly insurers should not be paying for Rx that cost less than , say, $50. We will then have less interruptions for prior auths , etc. Like the education industry (higher outside, gov’t funds available = higher tuition), if there is less insurance coverage for Rx, maybe Big pharma will be forced to lower overall costs. Please , we all know people on assistance who nonetheless think nothing of buying $8 cigarettes, etc.
    I realize that healthcare delivery is extremely complex, but I believe that some degree of returning to more simplicity will be monumentally beneficial to patients (but they have buy in and start being more responsible). Oh well, keep on keeping on…Best regards

  2. PNHP (Physicians for a National Health Program) has ideas for changing our flawed health care system

  3. Who has any ideas for real reform?”
    Linda, the horrible sad truth is those who CAN implement REAL reform, don’t want to.
    They don’t care (anymore.)
    The status quo and worsening suits them just fine.
    Sorry doctor, but they make money, money, money.
    Money in of itself is not bad – it is what we do or don’t do with it that colors the picture – improving lives, creating health or destroying lives and creating only wealth (for some.)
    The choice remains ours.
    After 34 years of having been qualified in medicine I will continue to (naively) believe I can fulfill my calling of being a healer, and promote health.
    I know, we (well some of us) will not give up.
    Many colleagues scorn and scoff – the only parameter is fame and wealth.
    A practical first step will be to go back to basics in medicine – teach and apply lifestyle medicine – effective but inexpensive Rx for 60-80% of what ail our patients.
    It won’t happen, unless and until, we become brave enough to acknowledge we are in trouble with medicine.
    Thanks for speaking up, Linda!

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