Project 21 New Visions

Elaina F. George, MD

Health Insurance Reform Does Not Equal Good Healthcare


by Elaina F. George, MD (bio)

 

ObamaCare was peddled as a solution to America's health care troubles. Enticing promises were made to garner support.
 
It was sold, however, without regard for the difference between health insurance reform and health care reform.
 
Our health care system is broken.  Costs are at unacceptable levels, but it's not because of doctors.
 
A progressive decrease in reimbursements, in fact, has made doctors less of a factor.   Costs are really being driven by hospitals, the pharmaceutical industry, compliance regulations and a food industry that contributes to rising chronic diseases such as obesity and diabetes.
 
ObamaCare won't fix these problems.  It actually doubles down on the root cause of rising costs by further empowering health insurance companies.
 
If ObamaCare's architects consulted practicing doctors, they might have learned that having health insurance doesn't equal having good health care.  That's an illogical belief when one considers that health insurance companies profit by collecting more in premiums than they pay out in claims. Insurance company CEO salaries suggest the industry is doing an excellent job, and the way ObamaCare was crafted guarantees that this status quo will continue.
 
Despite the rhetoric about change for the better, ObamaCare is having the opposite effect:

* Instead of slowing or decreasing health care costs, specific tenets of ObamaCare are causing costs to continue to rise.  It is hard to argue it was designed to decrease costs when it bans the use of health savings accounts to buy over-the-counter medication and doesn't allow access to cheaper drugs from abroad.
 
* Consolidation of hospitals has accelerated the decline of smaller community hospitals and independent outpatient surgery centers.  This shrinks lower-cost alternatives.  With favored hospitals being assigned patients over outpatient options such as a surgery center or independent radiology facility, health care prices skyrocket as cost controls and pricing transparency virtually disappear.
 
* The individual mandate, the most egregious portion of the bill, was revealed by the U.S. Supreme Court to be a tax.  It forces Americans to support an insurance industry that routinely rations care by limiting access through high deductibles, co-payments, pre-certifications, treatment restrictions and outright denials.  There was neither an attempt to rein in the abuse of patients by shifting costs and denying care nor any effort to stop the interference with the doctors' ability to provide treatments that they and their patients deem necessary.
 
* Doctor access has decreased due to the flight of independent doctors from private practice into employed positions in large groups and hospitals.  This moves patients into clinic settings with longer wait times for appointments.  
 
* Reliance on  "best practices" and restrictions/evidence-based medicine lowers the standard of medicine by making it one-size-fits-all.  Giving the pharmaceutical industry more power has a chilling effect by both increasing costs and focusing on the management of chronic disease instead of prevention.   This is inherently more expensive.
 
* Although pre-existing conditions allegedly cannot be denied, one can still be denied if the insurance company finds someone lied or made inadvertent mistakes on their application.  Individuals with pre-existing conditions may also be priced out by high premiums and deductibles.

True health care reform means limiting the power of insurance companies — not expanding it.
 
Over the last two years, insurance companies made record profits because people accessed their health care insurance less.  Having out-of-pocket expenses up to $10,000 for an individual policy, in addition to paying a premium, will do that.
 
The truth is that, although it makes a great rallying point, nothing is free.  ObamaCare costs patients more while they receive less care.  ObamaCare benefits the very corporate interests that profit by inserting themselves between doctors and patients.

Instead of stopping these problems, ObamaCare does virtually nothing because there is more money to be made on sickness than on health.

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Dr. Elaina George, a member of the national advisory council of the Project 21 black leadership network, is a board-certified otolaryngologist and host of a weekly talk radio show, "Medicine On Call," that explores health issues and the politics of medicine. Comments may be sent to [email protected].

Published by the National Center for Public Policy Research. Reprints permitted provided source is credited. New Visions Commentaries reflect the views of their author, and not necessarily those of Project 21, other Project 21 members, or the National Center for Public Policy Research, its board or staff.


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