Op-Med is a collection of original articles contributed by Doximity members.
Medical bills are a main reason why Americans go bankrupt. But our political leaders have hardly given this issue the airtime it deserves in the public eye.
Healthcare related bankruptcy is an important and disturbing fact in America — and one that not many doctors and medical establishment societies seem to know or care much about.
But, the truth is that millions of working and middle-class American families are falling through socioeconomic cracks — because hospitals and doctors’ offices are sending them to collection agencies.
And its not just the uninsured falling — even people with health insurance are falling to their medical co-pay bills. All they need is an unanticipated or chronic health condition, to feel a big bite out of their paychecks.
And though the Affordable Care Act is insuring more people on paper, it’s not doing nearly enough to prevent personal bankruptcies — certainly its not doing much to contain exorbitant and artificial costs.
When people get sick and are overwhelmed with the practical concerns of their day to day, it is very easy to fall behind on bills that end up in the hands of impersonal collection agencies with a single goal: to extract the money “owed”.
This is not right — and it is certainly inconsistent with the medical profession’s own ethos of protecting and preserving lives.
When nearly 20% of America’s Gross Domestic Product is devoted to the healthcare sector, how is it possible that healthcare is also a leading cause of personal bankruptcy in our nation?
The answer to this question is important and relatively simple: the price of healthcare, and its associated products, is not set using free market economic principles and metrics.
To the contrary, healthcare prices are set behind closed doors by industry advocates, lobbyists, medical establishment leaders and appointed, not elected, federal government bureaucrats — the consumer’s voice is very literally absent from the pricing equation.
How many patients even know the price of a healthcare service or product they receive? And how many actually understand the price structure? Even most doctors and healthcare practitioners themselves are oblivious to the price of their services — much less the patients.
Healthcare price setting is the domain of the medical and corporate elite. Yet it is working America feeling the pain of bankruptcy from unnervingly exorbitant healthcare prices. Many idealistic doctors, themselves, have become nothing more than corporate “cash-cows” for “big daddy”, who dictates their paychecks and promotions —many have no idea how some of their patients are being financially ravaged.
Americans with health problems requiring intervention by doctors and hospitals are some of the most vulnerable among us. No one wants to suffer or die — so not many patients are empowered to ask questions about or object to the price of services they receive. It’s the perfect and classical setup for the powerful to extort money from the vulnerable — in the style of the mafia. It’s a fact of history that when it’s one’s life at stake, most people are willing to pay any price.
And most patients don’t bother questioning their insurance companies as to why their copays are so high, or why a service is not covered — even forgetting about America’s uninsured, who are catastrophically exposed to begin with.
The fundamental fact that most citizens need to recognize is that healthcare prices are being set and protected by an industry and lobbyists who have seized control of our federal government and many congressional representatives.
This means that the power brokers of healthcare are setting the price of American medicine away from the public eye. It is not a balanced interaction between the supplier and the consumer dictating prices in our “free-market” nation — it is a mafia-like elite governing healthcare prices.
By effectively lobbying congress and federal agencies to preferentially protect the interests of doctors, hospitals and medical product manufacturers, the corporate wing of our healthcare sector has effectively departed from anything resembling free-market economics — to say nothing about medical ethics.
American Healthcare now operates using “mafia-like” economic tactics: by securing protectionist federal regulations, achieving obscene prices using legal mechanisms and under the guise of “R&D” cost, and by silencing dissent and criticism by physicians who see the ethical problem.
The healthcare sector, perhaps more than any other sector in today’s economy, poses an existential threat to America’s health and to the financial solvency of many American families — but almost none of our politicians are willing or able to articulate this fact clearly and forcefully.
But any decent politician or careful insurance executive, should recognize that as the baby-boomer generation reaches an age where its healthcare needs hit Medicare and our private insurers with its full force, the artificially exorbitant cost of healthcare products could critically deplete our health insurance investments and family savings. It is almost certain that the premium pay-in from the millions of Americans now insured by the ACA will be nowhere near sufficient to compensate for the catastrophic fiscal cliff the baby boom generation poses — especially at the current price structure.
Unless courageous congressional representatives — of the people, by the people and for the people — and healthcare executives can bring themselves to shut down outrageous healthcare prices, our healthcare sector is due to fall off what might be an irrecoverable fiscal cliff. Because, this sector is not playing by the simple and fair rules of an adequately-regulated free-market economy to set prices — instead it is designed to voluptuously draw exorbitant prices from our insurance investments and from American families’ hard earned savings.
This extortionist behavior of corporate healthcare in America forecasts a catastrophic collapse over the next decade — and with it many lives will be in harms way. This is a serious national health and economic security problem, no politician or federal agency has yet articulated with blunt clarity.
One thing is for sure, when our healthcare sector meets fiscal catastrophe, this president and his passe will blame “ObamaCare” for insuring a lot more people than the system could sustainably cover. This, instead of recognizing the precious time they are wasting in not regulating healthcare prices to a sane and ethical space guided by the real free-market economics of supply and demand.
The solution to preserving America’s health and wealth is not to insure fewer citizens, it’s to regulate the healthcare prices to sanity and prevent Americans with serious acute or chronic health conditions from falling into personal bankruptcy. But the trump administration seems to have little appreciation for this solution — despite its claims to “populism”.