News flash: the health care system needs to be changed. The system is broken. It is set up right now to encourage illness. Doctors have no incentive to make you well (other than ethics an d integrity). You as a patient are the source of income. If you get better and stop coming in, doctors don't get paid. That's how it is set up right now. You would think that the insurance companies would want you to be well because they only pay when you are sick. Occassionally they will pay for prevention visits. But not all do. Why not? Two words: money and risk. Insurance companies are willing to gamble and bet that they won't pay out more than you put in. Over the course of a year, how many times do you go to the doctor? If we are generous in our estimate (and for ease of math) let's say 10 times per year. Lets say the average doctor visit costs $90. That equals $900 assuming the insurance company pays 100% of the charges billed (which they never do). If the average monthly premium for an individual in their mid 30s is $300, over the course of 12 months they are paying $3600 (not counting copays or deductibles). The difference is $2700. From a business standpoint, who wins? INSURANCE COMPANY!! Who loses?? We all do - patients and doctors!! Insurance costs continue to rise. Reimbursement for physicians continues to go down. Offering insurance coverage for everyone is not the answer. It will only make the problem worse.
In order to change the system, we have to change our focus. We must focus on wellness rather than illness. Insurance companies should consider paying to keep people well. Doctors should be paid when their patients are well rather when they are sick. What if you paid the doctor to keep you well and never paid when you were sick? What if insurance paid for medical procedures that were unexpected or emergent only? What if doctors were compensated for how few times their patients came in rather than the opposite? What if people were responsible for their own health and forced to make changes rather than rely on drugs?
Take Diabetes, high cholesterol, and high blood pressure for example...Our system lacks personal responsibility. If you want to overeat and live a sedantary lifestyle, go for it! When you develop Type II diabetes, high cholesterol, and high blood pressure, your doctor will just give you some "prescription medications." And when those don't work (because you didn't change behavior), he or she will give you more. And when that doesn't work, and you have a heart attack, the doctor will do surgery. And guess what, insurance will pay for it all!! Hooray!! Thanks big insurance company. Thanks for the "health care." Gimme a break. What if insurance companies told people, "Stop eating crap, get off the couch and exercise, quit smoking cigarettes and drinking excessive amounts of alcohol and energy boosting drinks, and make some changes or else we aren't going to pay for your health care?" WOW. Sounds radical . Instead they just increaese the premiums across the board. We are all so brain washed into thinking that some chronic diseases are not our fault. And we are told they cannot be changed. "Once you have diabetes or high blood pressure you will be on medication forever." Bull. I have seen patients reverse high cholesterol in 3 months. Many cases of diabetes can be reversed - without drugs! IF the patient wants to change. In my experience, most patients don't want to change. It's too hard. Too much work. So by those patients choosing to not change, MY insurance cost goes up. Hey insurance company, stop paying for chronic diseases that can be reversed with diet and lifestyle changes. Or maybe pay for prescriptions ONLY AFTER aggressive lifestyle changes have been made...not just attempted but implemented. It's not rocket science. But not all doctors are trained to treat the cause. Many don't know how to sit down and talk to their patients about diet and lifestyle changes. They are in a hurry (and have to hurry to meet costs - an unfortunate "side effect" of the system). And besides, there are drugs that can alter the lab results for a short time which looks great on paper. Unfortunately drugs are often the only option a conventional doctor has to offer. It's sad really. Especially since the drugs are often nothing more than expensive band aids. Don't get me wrong, there is a time and a place for pharmaceuticals. I am not opposed to pharmaceuticals. If I have a bacterial infection, I want antibiotics. Nothing works like prednisone or albuterol. And when needed, they can be lifesaving treatments. But to prescribe a cholesterol lowering medication (Lipitor is the number one selling drug in the world), and NOT LOWER MY RISK OF HAVING A HEART ATTACK OR A STROKE...no thank you. What is the point in taking a drug that lowers numbers on a piece of paper but doesn't lower risk? For the patient, no point at all. For the drug company, big time money - billions of dollars. Does anyone else out there see the problem?
The problem isn't the poor people and the children that don't have health care. The problem is the system. The problem is big money in pharmaceuticals. If high cholesterol can be reversed or better yet prevented, there is no need for cholesterol lowering medications. No cholesterol lowering medications = no money. No money = no happy for big pharma. If I owned a pharmaceutical company, I wouldn't want you to get better either. Because then you wouldn't need my product. Lower the cost of medications, decrease incentive, and maybe things will change. But there is too much money right now in pharmaceuticals and no chance of that changing anytime soon. If the door is opened for everyone to have "health care" guess who wins? Big pharma!! The pharmaceutical industry wants socialized medicine. More demand = more $$$$$.
What can you do? Keep yourself healthy. Eat right. Exercise. Get a good night sleep. If demand for the medications is reduced (hopefully as a result of being healthy and not needing the drugs), production and costs have to go down. Then maybe the system will start to change.
