There is a major misconception about the reasons for the rise in the cost of healthcare. Procedures and the practice of defensive medicine have been described as the main reasons for the exponential rise. However, the reality could not be farther from what is portrayed on TV series like Nip/Tuck. The medical insurance industry has fueled the campaign of misinformation to enhance their divide and conquer strategy. As long as people spend their energy on blaming doctors, they have less energy to pay attention to rising deductibles, premiums and co-insurance. In short, the insurance companies benefit by keeping doctors and patients at odds. In reality when a doctor charges for a procedure or performs a surgery what is paid is no where near the amount that was charged. In short, the increase in patient premiums, deductibles etc… have gone to pay administrative costs and CEO salaries.
These are 6 things you need to know so you can understand the barriers your doctor has to navigate to take good care of you:
- Insurance companies change what they will pay for
Through the pre-certification process, insurance companies will change what services they will reimburse. This list can change yearly. It is driven by insurance company costs and not by medical necessity as determined by the doctor and the patient.