When under the care of a doctor, even if they are well informed and knowledgeable of one’s condition, they may not be able to assist to the best of their abilities. Health insurance has significant influence over what doctors can and can’t do for their patients. In many cases the guidelines of the insurance company limit treatment and cause patients to receive suboptimal care. Regardless if one is a medical practitioner or a patient, it is critical to have a strong understanding of how health insurance impacts one’s medical care and by extension, health.
The Troubles with Insurance
Generally speaking patients working with physicians are able to discover their needs and correctly identify quality care. Unfortunately, insurance companies rarely match or surpass their expectations. Because insurance at its core is a business, the primary factor driving coverage and treatment quality is cost. The intense competition in this field has pushed companies to reduce costs by any means necessary. This has resulted in many companies reducing coverage to the bare minimum and settling for suboptimal methods of treatment. Instead of aiding patients and doctors in acquiring the correct treatment, insurance companies frequently push them towards a “comparable” alternative that rarely ever equates to the same quality.
In many ways, doctors have lost control over treatment selection. Insurance companies have usurped trained medical practitioners in dictating methods for diagnoses, treatment, and even patient doctor interaction. Some companies require specific treatments and events such as vaccines, well-visits, screenings, and mandated visits that if not completed by the physician, result in penalties. This breeds a uniform and unbending model of healthcare that may provide some benefit but is certainly not optimal.
The Cost of Care
Many physicians believe that practices and standards enforced by insurance companies reduce care quality and do not have the patient’s health as their main focus. Because cost is a primary concern, many companies encourage physicians to direct patients to other hospitals and specialists based solely on price point. It would be best if patients were given an opportunity to explore various options and decide for themselves rather than be placed in the care of someone based entirely on monetary factors.
Shorter doctor-patient consultations that are less informative are also promoted by insurance companies. Less time spent with a doctor and less information given on more costly medications and treatments reduces the likelihood that patients will want to pursue costly medications and procedures. Without being informed of these options patients are unable to consider them even if they are the best option available to treat their condition. Further stress is placed on doctors and their consultations with the increasing level of paperwork and pre-authorization needed for even simple tests and treatments. This has a dual impact of increasing doctor workload and reducing quality time with the patient. Lowering doctor-patient interactions negatively impacts a doctor’s ability to diagnose and treat patients.
It is frequently the case that insurance companies promote practices that are outdated or unsubstantiated by current medical research. One example of this is that a doctor may be penalized for not having all women over 40 in his care get a mammogram. This is inappropriate as more recent research has shown that women should have regularly scheduled mammograms only after the age of 45. Excessive and early screening ultimately costs more money and exposes women to unnecessary levels of radiation.
Healthcare as a money centered business has caused a significant decrease in care quality. Unfortunately, people with the most complicated and challenging conditions are the ones who suffer most.
The Biggest Losers
Chronic conditions and complex diseases pose a serious problem for those with inadequate healthcare. Most of the time, because companies frequently dictate the means of treatment and what approach to take, complicated health issues can be mistreated or go undiagnosed. This is dangerous as many chronic conditions such as chronic fatigue syndrome, fibromyalgia, Lyme disease, and thyroid disorders can be worsened with improper care and lack of recognition. Such conditions are difficult enough for doctors to diagnose and treat without the added layer of insurance pressures and treatment mandates.
Health care companies influencing medical decisions in regard to chronic conditions are frequently ineffective or worse. Those suffering from chronic conditions regularly experience failed treatments or inadequate testing that ultimately leaves them struggling to combat a condition that may be better treated outside the influence of a health insurance company.
What’s the Alternative?
It may seem impossible to acquire good healthcare without health insurance. However, there are many independent healthcare providers and doctors who have intentionally decided to work outside the bounds of insurance companies. Being free of limitations and mandated practices causes these physicians to be better equipped to service individual patient needs. These types of doctors are generally more willing to discuss and explore information and studies researched by their patients, order a wider range of tests, and explore new treatment options.
It is common for doctors working in this manner to garner a smaller pay check but they are frequently more motivated and focused on providing quality care for their patients. The unfortunate reality is that medical services without the assistance of insurance are going to cost more for the patient. However, paying for greater quality care allows one to maintain better health for longer, which translates to fewer medical expenses in the long term. Healthcare done in this manner also gives one the peace of mind knowing that their health care professional is not beholden to other businesses and corporations.
Acquiring Quality Healthcare
The Holtorf Medical group works without a governing insurance company because they want to provide the best quality treatment possible. Because their medical professionals are not forced to practice with ineffective and outdated treatments or test using practices focused on the majority they are better able to help the individual. Doctors who are free to speak with their patients and understand their concerns and conditions are more effective at diagnosing and treating the individual. By focusing on patient wellness and not insurance mandated regulations doctors can provide greater care and treatment.