As Health Insurance Influence Grows, Patients and Doctors Suffer

 Nearly one in ten doctors in the United States are employed by United Health, according to a recent investigation from STAT.  

It’s a troubling statistic for an ever-consolidating healthcare market that has drastic implications for patients. United Health Group’s (UHG) influence matters, as it covers nearly 30 million Americans and has the lion’s share of the insurance market. Yet between UHG’s consolidation and a massive cyberattack that revealed the company's lack of protections for patient data, the industry titan's reputation as a reliable payer is backsliding.  

It’s a symptom of a larger problem: large insurers like UHG are shifting priorities away from helping patients and toward maximizing profits. Yet taxpayers continue to bankroll these industries without consequence through trillion-dollar government subsidies. 

It’s past time for lawmakers to recognize this issue. Instead of accepting the status quo from insurance interests, U.S. policymakers should embrace healthcare policy that funds patients directly.  

As insurers continue to push the envelope on their financial goals, care suffers. STAT’s investigation highlights high costs and poor quality of medical care proliferating through UHG-affiliated medical facilities. UnitedHealth also sidelines quality of care in favor of moving through appointments as fast as possible. UHG physicians are often encouraged to take up to four patient appointments per hour, often leaving patients with more questions than answers about their illnesses.  

Short appointment times hurt doctors that care. With rosters of up to 30 patients per day, physicians can’t feasibly treat every patient, accurately diagnose them, and prescribe them with treatment or a follow-up appointment in a mere 15 minutes.  

This vicious cycle causes an endless back and forth of physician and patient burnout, leaving doctors underpaid and overworked, and patients not seeking out necessary medical care. More than 100 million Americans don’t have a primary care provider, and over half of all U.S. physicians reported burnout in the last year.  

The issue boils down to insurance companies gutting the purpose of healthcare by taking focus away from treatment and managing patients like financial assets. Americans don’t want to feel like they’re pawns in a larger game between health insurance companies vying to make record profits. They want to receive proper medical care and not have their tax dollars go towards backward insurance interests. 

Lawmakers should pursue patient-focused policies that allow freedom of choice, direct physician interaction, and fewer middlemen to encounter as patients seek out this care.  

These movements are already happening independently. Doctors nationwide are pursuing Direct Primary Care (DPC) as an alternative option to the status quo. DPC allows patients to purchase health care directly from their provider without any go-between from insurance. I know the benefits firsthand. We get to practice medicine the right way by meeting with patients for longer and treating them at affordable prices. These plans also reduce administrative work, simplify reimbursement rates, and cut operating costs by up to 40 percent. 

It’s an even better deal for patients. A doctor’s visit would now be as simple as scheduling an appointment directly with their primary care provider, receiving a diagnosis, and procuring treatment. No longer would a patient have to frantically check if their doctor is in their insurance network or be denied treatment based on a set of predetermined factors. DPC patients also have historically reduced appointment fees, some by up to 50% over the typical market rate. 

A few might argue Direct Primary Care doesn’t take enough steps to cover every possible medical situation. Some emergency hospital stays and specialty care may not qualify under DPC. Yet traditional insurance doesn’t make these emergency situations any easier to navigate, with often thousand-dollar fees for visits that do not go back directly to the physicians. Direct Primary Care is transparent, with fees and quality of care readily available for patients to assess themselves and can also help low-income Americans who typically struggle to find a primary care doctor and end up getting sicker as a result. 

What insurance companies seem to forget is that healthcare is about people, not how much money these people spend or what tiers of treatment they qualify for. Direct Primary Care forgoes these nominal estimates and gets down to what matters: receiving care. 

If Congress and other policymakers want to hold companies like United Healthcare accountable, they should look to new healthcare policies that take the middleman out of the equation. 

Dr. Juliette Madrigal has been a physician in the Highland Lakes Area for 19 years. She has her own medical practice where she treats people with cancer for free, gives a discount to teachers and preachers and still makes house calls. Dr. Madrigal is also the Burnet County Health Authority, and the Medical Director for Marble Falls and Horseshoe Bay Fire Departments as well as the MFHS EMT program. 

https://www.realclearhealth.com/blog/2024/09/20/as_health_insurance_influence_grows_patients_and_doctors_suffer_1059857.html