Earlier this year, my mother made a hard choice. After reviewing her medical history with her physician, she chose to have a preventative double mastectomy and hysterectomy. Her employer-based insurance did not question the procedures. Four months later, her incisions began opening and her physician determined she needed a second, outpatient surgery.
While recovering in the outpatient ward, my mother learned that her insurance company decided the procedure was “unnecessary” and would not approve the equipment she needed in our house, post operation. What was supposed to be a one-day trip to the hospital turned into a four-night stay, with my mother caught in the middle of her surgeon and her insurance provider. Her doctor felt overwhelmed; he knew what she needed in order to become well, but he wasn’t able to provide it or help to get her home.
At a complete loss of what to do, her surgeon expressed his frustration with being unable to help his patient until the insurance provider said he could.
Stories like my mother’s aren’t uncommon. Insurance company intrusions into the medical process take time away from physician-patient contact and the care that patients seek. As the bureaucracy of the medical insurance field grows, these time burdensome and costly requirements are hurting patients by pushing physicians more and more out of the picture.
And many physicians are deciding they’ve had enough.
Every year, the number of Americans with health needs that require professional attention grows. Health expenditures are expected to grow 5.5 percent every year from 2018-2027. In 2017, 85.1 percent of adults had some contact with a medical professional. Yet the medical field is not growing at a rate that matches demand, with projections estimating that the U.S. will have a shortage of more than 120,000 doctors by 2030.
Burnout among physicians has been growing over time, while remaining stable among other careers. It is also statistically higher in nurses, physician assistants, nurse practitioners, and medical students than their age-similar peers. This can lead to medical errors and lower patient satisfaction.
Physicians Foundation found that in 2018, 46 percent of physicians surveyed would consider a career change. The survey also noted that 37.7 percent of physicians say that regulations and insurance requirements cause them dissatisfaction and take away from their intended purpose — to care for people.
Currently, for every hour that a physician spends with a patient, two hours are spent working away from patients at a computer. That’s time that could be spent on interacting with more patients. But it’s being redirected to burdensome paperwork.
The inclusion of health insurance does not make the quality of care better. Looking at my mother’s experience, the company acted not just as the insurer, covering her care, but as the physician, deciding that she didn’t need the equipment the doctor prescribed. Her care was being determined by an insurer that had never stepped inside her hospital room.
Health insurance companies have seized too much power in the health care process. They should be in the business of funding care, not determining what type of care you will get.
As more and more of the U.S. population ages into Medicare, more and more physicians will be needed to meet the demand. For the sake of patient care and needs, our health care industry must focus on what really matters — the cooperative relationship between doctors and patients, not the adversarial relationship between patients and their insurance companies.
Otherwise, we’ll see even more physicians leaving the field.
Elizabeth O’Connor is a legislative fellow at the Texas Public Policy Foundation. She has a masters in Public Service and Administration from the Bush School of Government and Public Service at Texas A&M University and has studied at Manhattan College and Trinity University, Dublin.