I am speaking as a Pediatrician (primary care professional) stuck in the system, trying to maintain autonomy in private practice as a small business type model and not be forced into corporate medicine as has been the fate of many of my colleagues, absorbed into volume and protocol driven automated medicine. Ours is among the few professions that do not receive what we charge as fee for service and we have to accept the contracted rates offered by insurance companies or face being excluded from participating physician panels and lose those patients to another physician who will accept the conditions.
Healthcare insurance companies should not be on the stock market. If making $millions-$billions in profits, then those profits should be used to decrease premiums to patients, extend covered services and increase pay to primary care physicians, who perform the bulk of the work but are being used to the point of burn out in an unsustainable squeeze that has lost physician control of our profession.
Present private for profit mega insurance conglomerate corporations are already corrupted, they are patient life mongers then use premium gouging after monopolizing the industry, they hold all of the power, they can legally prevent physicians from “cost” setting but yet they, as a double standard, can establish ‘Reasonable and Customary Charges’ fee schedule albeit “payment” setting shared amongst themselves that contracted physicians can’t share individually with colleagues for comparison and they use a defunct unfair unit of measurement (relatively unchanged in > 25 years) to calculate current reimbursement rates (trailing far behind the rate of inflation) based on 150% of Medicare reimbursements for same services.
How can you, as a payor, use a fixed federal government public payment system, which has no profit, no shareholders and is not privatized; to determine and set your commercial system’s reimbursements paid to healthcare systems, your payee, while you steadily increase premiums, deductibles, coinsurance and other risk sharing out of pocket costs per covered lives, costs turfed to patients; making the insured more responsible and the insurer less responsible for paying covered expenses, creating more capital gain… All while being profit driven, shareholder beholden, and privatized… Sounds like a conflict of interest to me… ???🤔
How can healthcare insurance companies’ comptrollers and state insurance commissioners justify increasing premiums > 800% while having record profits?
Pharmaceutical companies should not be on the stock market. If making $millions-$billions in profits, then those profits should be used to pay for research trials, decrease cost of Rx, which in turn will help drive down premiums due to less risk to healthcare insurance companies.
How can pharmaceutical companies justify increasing prices on Rx by 3000 times, not allowing the production or importation of generic equivalents due to loopholes and manipulation of the patent marketing laws, while reporting record profits? Something is wrong with the insurance regulatory system. Something is wrong with the brand name to generic Pharmacuetical process.
There is something wrong in the ethics of healthcare when profit trumps quality of care and access to quality healthcare is for the wealthy while the poor remain disparaged and disenfranchised in a system without regulation and accountability of the entities in control of costs, corporate healthcare insurance companies and pharmaceutical companies…
But hey, dividends were paid!