News media are replete with stories about the killing of UnitedHealthcare CEO, Brian Thompson. While the murder mystery elements still dominate, a constant subtext is the perpetrator was angry at greedy insurance companies like UnitedHealthcare and frustrated that care is unaffordable and inaccessible.
With Trump in the White House and with the DOGE (Department of Government Efficiency) advising him how to improve efficiency of federal activities, radical reform may be possible, transforming healthcare to become affordable and accessible. Might there be anyone opposed to such transformation?” The surprising answer is, YES!
Who are these people? There are three reasons why some would resist: self-interest, wrong reform, and fear of change.
Self-interest
Insurance is a highly profitable industry. Any effective change in the healthcare system will direct more dollars to patient care and less to profit margins. The exact same effect would apply to pharmacy benefits managers, who generate profit for themselves and for health plans by diverting “healthcare” dollars from care providers to corporate bottom line. Both have powerful lobbies that will strongly oppose changing the status quo so favorable to them.
Any reform that improves affordability or access to care involves reducing the excessive regulatory burden. (Musk and Ramaswamy, please take note!) This will result is more money for care, less need for bureaucracy, and therefore fewer bureaucrats, administrators, regulators, oversight agents, compliance reviewers, and enforcement officers. In other words, nonclinical healthcare workers will lose their high payingjobs and will resist transformation.
While nonclinical healthcare workers will lose jobs, federal politicians will lose reliable, grateful voters and power. They will oppose healthcare transformation with great vehemence, especially with a complicit media at their disposal.
Wrong reform
There are some, with Bernie Sanders and Pramila Jayapal’s Medicare-for-All as prime examples, who think healthcare needs more regulation not less. They want total government control rather than any free market forces. They see no problem with the Medicare-for-All price tag of $40 trillion, likely to push the U.S. into insolvency. They reject or ignore the data showing that 31 percent to more than fifty percent of U.S. healthcare spending goes to bureaucracy and produces no care! They will vigorously resist transformation that away their control and returns it to We the People.
Fear of change
Most people fear change. The greater the change or the desirable the object being changed, the greater the fear. Transforming healthcare will be a huge, frightening change.
Nothing is more personal or more necessary than medical care. Washington and the complicit media have browbeaten Americans to believe that health care is a right; that government is responsible to deliver that right; that the government will expend taxpayer healthcare dollars wisely; and that Father (Washington) Knows Best what medical care Americans need. While none of this is true, many individuals have come to accept these falsehoods and will resist a transformation that takes decision-making power from government and gives it to individuals. People do not recognize, especially those in the lower income brackets, how good they are at making wise market choices and that they can do the same in healthcare.
The misinformation above, that is considered common wisdom, must be unlearned. Then, public resistance will fade away.
Providers of care will also initially resist healthcare transformation, thinking they will lose income in an unregulated market. Doctors are socialized not to compete with other doctors. So advertising, marketing and other seller activities common in a free market are anathema to them. Physicians have become used to having patients delivered to them. Doctor groups contract with health plans, become listed on the health plan panel, and patients are assigned to them from the panel.
Like the public, physicians need to be re-educated. They talk with their colleagues in direct-pay practices to discover their financial fears are groundless; how the practice of medicine, when relieved of the regulatory/administrative burden, reminds them why they became doctors; and how much happier their patients are when there is time to talk, one on one! In a transformed healthcare environment, those who provide prompt service and advertise their results and prices will be flooded with patients. Those physicians who do not will quickly find their waiting rooms empty.
Whether resistance to healthcare transformation is due to self-interest, ideologic demagoguery, or metathesiophobia (medical term for fear of change), the solution starts with dissemination of accurate information. Resistors will become advocates when they understand how transformation will benefit them: more money in their pockets, more affordable health care, and vastly improved medical service.
Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of Center for Healthcare Policy at Texas Public Policy Foundation; former Director of New Mexico Health Insurance Exchange; and author of 12 books, including multi-award winning, Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine. Follow him on X.com @DrDeaneW or contact viawww.deanewaldman.com.
