Health insurance does not equal healthcare.
Hi- Dr. Taylor, here.
I’m a doctor, a parent, and a patient myself. It’s taken me 15 years of doctoring to think I may finally have a grasp on the healthcare system in America. I’ll give you the overarching statement first: it is broken. Shattered into a million little pieces.
Health insurance does not make your care cheaper or better. In fact, often times it’s the opposite. Health insurance often makes your healthcare MORE expensive and lower quality.
I’ll highlight some of my own experiences as both doctor and patient to substantiate these wild claims.
I have health insurance. One time, I had an MRI of my brain. I got 3 separate bills for this one test. First it was for the MRI itself. Next up, it was for the radiologist to interpret it. Lastly, I got the facility fee for the hospital for using their equipment and space. Despite my in network insurance, I needed to pay roughly $800 out of pocket. Fast forward a few years later, a patient comes to see me in my office and something is acutely wrong. She has a staggered gait and a facial droop and unilateral weakness. Ellen, I said, (fake name), I think you had a stroke. Well, Ellen had just lost her health insurance due to job changes and bad luck. Gosh, if my MRI with insurance cost me $800, it must be thousands of dollars without insurance? How will she afford it? I picked up the phone and called radiology to explain the story, to which they replied- “oh, we have a cash price option for uninsured patients, it’s $500.” WHAT. The same study was cheaper without insurance than with insurance. Health insurance does not make your care more affordable.
Recently, I brought both my kids to the pediatrician for a sick visit. We have a high deductible plan. Weeks later, when the bill arrived in the mail- I trembled while opening it. Will it be $50? $500? Their viral URI visits cost me $350. Really makes you think the next time they have that fever. They’re probably fine? Maybe I’ll see how they are tomorrow? When you question whether or not you should bring your feverish kid to the pediatrician because you are worried about the bill, I think its safe to say that health insurance does not necessarily yield better health.
We pay more for healthcare than any other modern country. (citation). Deductibles have increased 160% over the last ten years. (citation). Doctors are actually being paid significantly less than what they were paid 20 years ago (citation). And medicare recently proposed another 2.5% decrease in reimbursements to doctors, which means we will need to see XX more in a day just stay whole. Meanwhile, United Healthcare profited *** in Q3 of 2024. (citation).
Patients are suffering. They say, “that doc spent 5 minutes with me, dismissed most of what I needed to talk about and then had the audacity to send me a bill for $250”
The doctors are suffering. They say “did I really go to medical school, take on hundreds of thousands of dollars of student loans, work 80 hours a week during residency- for an insurance company to tell me that there is not a single inhaler for asthma that is covered for my patient? Did I spend my whole life training in medicine, so that I can spend an hour on the phone with them to remind them that a $200 inhaler is way less expensive than the hospitalization for an asthma exacerbation?”
We are all suffering in this model.
Well, that’s not entirely true. The insurance companies are thriving.
Direct primary care is a movement. Doctors are finally leaving the system thats been taking advantage of us and profiting on our hard work. We realize that we can provide care much more efficiently and much more affordably when we take out the middle man. Patients are finally realizing that despite their insured status, they’re not any healthier when they have to push off medical care due to fear of costs, or when they do meet with their doctor- she is haggard, burnt out, and exhausted for trying to take good care of a folks in a system that is broken and shattered into a million little pieces.
