Medical Insurance Has Become a Disease in the United States

  • Post category:Opinion

A Taste of Our Own Medicine

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Technicality, Oh Technicality, all life is technicality. The mantra of the modern medical industry. Our national medical system has reached a point where the interrelationship between big pharma and the medical insurance industry has crippled the system’s ability to provide quality, on time health care to millions of Americans. 

These changes would allow the system to grow and to help us toward a better future.

As with everything, the more the government attempts to get involved with it the worse things get. Insurance, HMOs, personal plans and Obamacare simply increased the cost of healthcare for people around the country. Now we once again stand at a precipice of an election where both parties are using healthcare as an electioneering tool, not as a campaign promise that they intend to keep.

A Nation Addicted

Within this field there are three distinct areas that we need to look at. The first is actual medical care. As a nation, we have become addicted to the treatment and not looking for the cure. Our internal medicine system looks for problems while they are supposed to be treating problems we already know. This results in a compromising effect of people being diagnosed with things that, guess what, require more medication. 

It becomes an endless cycle of treating the side effects of a given medication with another medication that will have its own set of side effects. This is a horrible system that causes people to be chemically dependent and is widely seen as a cause of the opioid epidemic. We need to rebuild a system where doctors treat people as people, not medication storage units. The more we give doctors the chance to heal people, the more we will see actual healing rather than doctors forced to prescribe medications just to avoid malpractice suits.

Pharmaceutical Kickback Side Effects

The second area that we need to look at is the “gifting” within the prescription drug market. Hospitals and doctors receive kickbacks for using pharmaceutical products at a certain level. Yes, this is illegal. However, there is a limited response to the problem- which generally punishes the doctor and gives the drug company a slap on the wrist. 

This is akin to sending a hooker to jail for life, but then giving the “john” a fine which is equal to the amount he paid the hooker (which he got back anyway). The punishment needs to be directed and its focus aimed at the pharmaceutical companies, punishing them heavily for attempting to influence doctors to prescribe medications that they do not need.

Small Steps Save Lives

The third area, while we are on the subject, is why are doctors prescribing medications anyway. We live in a society where everyone has multiple doctors or no “family doctor.” This means that many people see a different person every time that they go for treatment. When this happens, the files do not always represent the medications that they are receiving. Doctors should identify the disease and try to treat it without medication; if they cannot, they should send the diagnosis to a pharmacist of choice for the patient.

The pharmacist reviews the diagnosis and prescribes medicine in line with what will be the most effective. This would allow the pharmacies (which are generally controlled by three entities nationwide) to have a clearing house where the pharmacist (who is almost always a doctor of pharmacology) to see what drugs will react with another or see if the patient has been scamming multiple doctors for pain killers. This small step alone would save thousands of lives each year.  

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Medical Insurance

Medical Insurance is a Scam

The final thing that we need to discuss in this matter is the ability of insurance companies to deny service. I will just go ahead and say it, medical insurance has become a scam. People pay thousands of dollars into their premiums, thousands more into deductibles only to be told that the treatment that their doctor says they need is not covered. Why? What is the point of medical insurance if it is not covered? The United States government should scrap the current health code and replace it with a simple health code. Here is a sample:

“Clause 1: Any person who obtains insurance through an insurance plan shall receive any treatment that is prescribed by their physician or any licensed physician. A dispute by the insurance company must be filed with the institution after the treatment is received. Insurance company may not deny services which are prescribed by a doctor, nor may they exclude FDA approved treatments from plans.

Clause 2: A person may not be denied access to health insurance based on any pre-existing condition.  Premiums may not be more than 10% of average of health insurance premiums for the persons age range 0-30, 30-60, 60- end of life).  Insurance companies must, within 5 years of the passage of this bill, be registered as not-for-profit companies.

Clause 3: If a person cannot afford health care, as defined by the Dept of Health and Human Services, then they qualify for medical assistance.  Person’s pay 5% of their unadjusted gross income (including other assistance) for insurance and receive full coverage. Medicare and Medicaid are combined into Government Healthcare plan, which is available for anyone who has income below the amount assessed by the Department of Health and Human Services. People within this category may have their healthcare covered by a private insurer, if the cost is less than the amount which the government health care package is assessed at.

Clause 4: Deductibles are prohibited.”

No Need to “Feed” Shareholders

While the industry will have an outcry about this, they will find a way to maintain the system within these rules.  As these companies are no-longer for-profit companies, the need to “feed” shareholders is eliminated. There are several successful non-profit health care companies now, big companies will adjust to this model. While these suggestions will not solve the problem of our failing health care system, they will help stem the tide of decay. 

Everyone should have access to affordable healthcare, but no one has a right to the products of another person’s work. This is troubling as the moral principle is weighed against the legal principle. As a nation, we must come together and help to find a way to provide people with the care they need; however, when we are relying on the government to do so we are not being altruistic, we are being lazy. These changes would allow the system to grow and to help us toward a better future.

Christopher W Smithmyer
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