Why Do Americans Settle for Our Broken Health Care System?
It is no secret the U.S. health care system is badly broken. From the lack of transparency and inflated billing to a looming physician shortage, everyone suffers.
In recent years, significant resources and attention have been dedicated to researching and discussing various perceived problems in the current system, and the list of flaws is seemingly endless. For starters, it is next to impossible for many sick patients to set an appointment with a primary care provider within 24–48 hours. (That’s why there’s now a whole industry of walk-in clinics that has emerged in recent years.) And when primary care office visits finally do occur, often after a few weeks of waiting, they usually last under 10 minutes. The hurried physicians hosting such visits are typically so busy that they don’t even have time to maintain eye contact, because they have to enter mountains of data into their electronic heath records database.
Many patients are allowed only one complaint per visit, and having no time, primary care physicians often can do little more than generate a referral to some other highly-paid medical specialist, which forces patients to spend yet another day waiting around a doctor’s office—after weeks or months of waiting for another appointment.
And let’s not forget about insurance. Despite billions of dollars spent by governments, it remains terribly expensive. Deductibles and premiums combined cost millions of families at least as much as a second mortgage or rent payment would. Deductibles of $7,000 are now commonplace, and it is not unusual for a family purchasing insurance in an Obamacare exchange to pay in excess of
Even after a deductible has been met, many insurance plans pay only 60–80 percent of the overpriced cost of care. And this typically lasts for just a few months before the deductible resets, usually on January 1. That means many patients pay out-of-pocket costs for much of their care, whether they are insured or not.
These topics, and many more, have been extensively analyzed by policymakers and academics. But while all these issues are important, one area that continues to be overlooked is patients’ behavior—more specifically, the fact that there has not been a rebellion against this severely broken system. Don’t get us wrong. We’re not blaming the “victims”—the patients—for the numerous issues plaguing the current health care model. Patients and their family members are the ones who suffer the most! However, if we, as health care professionals, should understand why a battered spouse continues to stay with an abusive partner, we should also try to comprehend why patients continue to use and defend such a dysfunctional system.
You might be thinking that the primary reason most Americans continue to put up with the traditional model is because there aren’t any good alternatives, but that’s simply not true. For example, membership in a healthsharing organization can cost as little as $429 per month for a family of four, much less than the premiums now offered in Obamacare health insurance exchanges. In the past, healthsharing organizations were faith-based, but recently several have formed that are not affiliated with a religious group. Generally, these organizations do not force consumers to use a specific network of providers, and the unshared cost of a health service (which is similar to a deductible in traditional health insurance plans) tends to range between $500 and $1,000, much lower than the deductibles most people pay.
Similarly, direct primary care (DPC) practices, a new and innovative membership model of health care delivery, provides primary care services—which account for about three-fourths of all medical visits—for about $40 to $100 per month. These doctors also frequently have in-office pharmacies that dispense medications for much less than traditional pharmacies. They also have access to inexpensive labs and wholesale pricing on imaging services.
By combining membership in a DPC practice with a membership in a healthsharing coverage option, families now purchasing an Obamacare plan can save $6,000 per year or more—all while having more and better health care choices.
Millions of Americans have never heard of these options, but even among those who have, there’s a lot of skepticism. One of the authors was even warned by family members that DPC must be a scam. In our experience, upon hearing about these innovate services, many patients promptly deny the possibility that such high-quality, low-cost options exist, and they then attempt to defend the same highly dysfunctional system that abuses them. If any other industry were to offer such bad products at similarly outrageous prices, consumers would immediately abandon it. But this is not the case with the current health care system.
There are no rallies against laws that prohibit surgeons from owning new outpatient surgical centers, as former President Barack Obama’s Affordable Care Act does. There is virtually no public outcry about the dozens of state “certificate-of-need” laws requiring hospitals to get permission from bureaucrats with no medical expertise before buying new MRI machines or adding more beds.
Why would so many otherwise intelligent and savvy consumers do nothing to combat these problems? Is it possible that Stockholm syndrome plays a part, at least among those who have heard of the numerous health care alternatives we discussed above?
Perhaps people have become so dependent on the current model that many can no longer see it for what it really is: a highly abusive captor that is using and abusing consumers. Politicians, special-interest groups, and many giant multinational corporations all make out under the current system. But you lose. It’s time for Americans to rethink health care reform.
Chad Savage, M.D. (firstname.lastname@example.org) is a policy fellow at the Docs 4 Patient Care Foundation and the founder of the DPC practice YourChoice Direct Care in Brighton, Michigan. Gabriela Eyal, Psy.D., is a licensed psychologist in Lansing, Michigan.