Published: 2009-08-18 22:34:11
Author: Russell Turk, M.D. | Daily Finance | July 18, 2009
Of all the problems with the current health care system, perhaps the most insidious is that the system is fueled by special interest groups, whose chief concern is their own bottom line.
There are a lot of hands in the pot: insurance companies, drug makers, hospitals, device and equipment manufacturers, and yes, doctors. They all pay lobbyists huge sums of money to convince legislators to maintain the status quo, or to draft legislation in their favor. But unless these groups agree on a solution that will overhaul our system, costs will continue to rise and the quality of care will fall.
We have already seen signs that special interest groups are willing to play nice because they all want to be included in health care reform discussions. But keep in mind that special interests ended up killing Hillary Clinton's efforts at health care reform in the 1990s. More importantly, the companies and groups profiting from the current system have a lot at stake.
Let's start with the insurance companies. It's no surprise that profits at ten of the country's largest health insurance companies increased 428 percent from 2000 to 2007, according to Health Care for America Now (HCAN), a grassroots lobbying group. HCAN also reports that the CEOs of these companies earned on average, $11.9 million each -- a combined total compensation of $118.6 million.
They've done this by using practices that are both well-documented and despicable -- refusing insurance to people with pre-existing conditions, denying care based on technicalities, and raising premiums for employer-based health insurance 120 percent since 1999, according to the National Coalition on Healthcare. From a doctor's perspective, the insurers also create arbitrary coding and credentialing guidelines contrary to those proposed as fair by large physician organizations, which serves to reduce compensation.
I could go on and on, but let's move on to other players whose practices drive up health care costs. A big problem is that the medical industrial complex is creating demand for expensive new drugs, procedures, medicines and technologies, but we don't know whether many of these new technologies are cost-effective. As I've pointed out in an earlier column, research comparing the effectiveness of various treatments and drugs is sorely needed so physicians will have a clearer idea if a more costly treatment is actually more effective than cheaper alternatives.
For example, in my field, gynecology, preliminary research has shown robotic surgery to be promising in terms of treating women's health problems less invasively than traditional surgery. Its advantages over other minimally invasive techniques using laparoscopy have not been clearly demonstrated, however.