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Deane Waldman Headshot

Scum of the earth - NOT!

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We have had this talk before but apparently lots of you missed class that day. If you review the post "The Future of Healthcare" as well as others prior to it, you will see great streams of anger directed against the "blood-sucking," heartless" evil insurance companies. I often feel the same anger when I am a patient and even more as a physician trying to get good care for my patients. I do not want to apologize for the insurance companies but to be fair, I must.

It's not their fault. It is the system. Let me say that again: the problem is how we finance medical care, not the insurance companies. They are responding to a fundamentally flawed system that generates profit by avoiding or delaying care. If you work for any large corporation, you almost certainly have a pension plan that holds insurance companies stock. When insurance denies medical care, they are making money for you.

As a patient you want care. As a stockholder, you want care to be delayed or denied. This contradiction is brought to you by your friendly neighborhood healthcare (non-) system, not by the insurance companies.

The loudly touted solution is a single payer system. Advocates reason that if the government is the sole payer, there will be no profit motive and we will get all the care we want. Nice hope but wrong.

The Government may not have a profit motive like an insurance company but it certainly has financial motives. As long as healthcare dollars are paid primarily for sickness care rather than for being healthy or for restoring health, we will get perverse outcomes. The way the system is currently structured, we pay for what we do not want rather than what we do want.

A system that works will pay for: pain-free movement after back surgery; climbing stairs after a heart attack (watch the movie Something's Gotta Give and you will understand); reduced cholesterol on follow-up testing; and good vision (no blindness) despite having diabetes.

We need to change the whole system rather than just who controls our healthcare dollars.