Fake repeal-and-replace legislation fails to reform health care

Marcy ZwellingUncategorizedLeave a Comment


Fake repeal-and-replace legislation fails to reform health care


2017-03-16 16:00:05

The Republican Affordable Care Act repeal-and-replace bill is public and the Congressional Budget Office report is out. The likelihood that the number of uninsured could actually go up in spite of legislation meant to “cure” all that ails our health care delivery system has animated the media into a frenzy. But whatever the ultimate number of uninsured, this legislation has little chance of reforming the health care marketplace. That’s because it doesn’t address the problem; it exacerbates it. The nation is once again throwing money at the very heart of the dragon.

The exorbitant cost of health care owes its excess to the insurance industry and a cadre of third-party players and interlopers like pharmacy benefit managers. It is silly that

we continue to allow the insurance industry to sell us on the idea that the gateway to care is through insurance. This is even more absurd as patients and physicians find themselves wasting millions of dollars in time and paper marching through an authorization protocol that only serves to obstruct access.

It’s fallacious to pretend that these health care “insurers” are selling insurance when they are really peddling a benefit plan tied to a (promised) network of physicians. And it is even more deceptive to fantasize that a California patient would choose a network of Minnesota doctors in order to save money and buy a policy across state lines.

Speaking for America’s working physicians, we want reforms that will allow us to do our jobs better without government or other third-party interference. It’s about time President Donald Trump and Congress ask those of us who know this business and live this business how to run this business.

Legitimate reform is straightforward and can easily be accomplished. President Trump would be wise to lead these reform efforts by using his pen to mandate that patients have access to the retail/cash ”real” cost of their care. In order to promote patient choice, the patients must be informed and given the option to pay for their care with insurance or cash. By creating this level of transparency, the marketplace becomes an active means to conduct health care transactions; to open up a competitive market where quality goes up and costs go down.

This has been proven by those physicians involved in direct primary care or those practicing “concierge” medicine where patients find same-day access while spending fewer dollars for the insurance (a bare bones catastrophic plan). These same patients spend less for care and cut their emergency room visits by 25 percent. (MDVIP study Personalized Preventive Care Reduces Healthcare Expenditures Among Medicare Advantage Beneficiaries, 2014.)

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Print Article: Fake repeal-and-replace legislation fails to reform health care 3/18/17, 2:53 PM

While Congress and the media debate the nuances of an insurance industry that is broken and abusive of its clients and while they turn a blind eye to the influence of the third-party interlopers who serve only to profligately drain the system of much-needed dollars, President Trump can truly start to “drain the swamp.”

This simple executive order costs nothing but is a priceless opportunity to lead the nation’s health care reform efforts. It establishes a healthy conversation about the things that matter most in any health care delivery system, the sanctity of the patient/physician relationship and individual patient choice.

Marcy L. Zwelling-Aamot, MD FACEP, is chair of the National Physicians’ Council on HealthCare Policy

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