{"id":3174,"date":"2021-04-21T20:46:06","date_gmt":"2021-04-21T20:46:06","guid":{"rendered":"https:\/\/healthdrum.com\/?p=3174"},"modified":"2021-10-12T16:19:28","modified_gmt":"2021-10-12T16:19:28","slug":"health-insurance-sickens-healthcare","status":"publish","type":"post","link":"https:\/\/healthdrum.com\/blog\/health-insurance-sickens-healthcare\/","title":{"rendered":"Health Insurance Sickens Healthcare"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Healthcare is a terminal illness for America\u2019s governments and businesses &#8211; Clayton Christensen, \u201cThe Innovator\u2019s Prescription\u201d.\u00a0<\/span><\/p>\n<p><b>Health insurance for catastrophic care makes sense.<br \/>\n<\/b><span style=\"font-weight: 400;\">Health insurance emerged in the 1920s and makes sense to hedge against the cost of unlikely hospital care for a financially catastrophic illness.<\/span><\/p>\n<p><b>Health insurance for routine care does not make sense.<br \/>\n<\/b><span style=\"font-weight: 400;\">Health insurance to cover low cost, routine care that has a high probability of recurrence and is not financially devastating makes little sense. For example, your car insurance doesn\u2019t cover the cost of a new tire.\u00a0<\/span><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some two thirds of the healthcare delivered in the U.S. is generally affordable office-based and outpatient care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">To control access and delivery of care health insurance companies \u201crules\u201d have resulted in 1\/3 of the $3.6 trillion dollar healthcare market being spent on administration services &#8211; these costs are passed onto patients and providers and make insurance-covered routine care very expensive.<\/span><\/li>\n<\/ul>\n<p><b>Who accounts for health costs?<br \/>\n<\/b><span style=\"font-weight: 400;\">Only a few people account for big health related expenses.<\/span><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">20 percent of the population accounts for 80 percent of health costs.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">5 percent of the population accounts for 50 percent of health costs.<\/span><\/li>\n<\/ul>\n<p><b>Most people overpay for healthcare by being over-insured.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The chance of a financially catastrophic illness is low.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Most people pay for their plan and still pay for routine care with copays, deductibles and non-covered services.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">For most people their health insurance plan kicks-in little or nothing.<\/span><\/li>\n<\/ul>\n<p><b>Health plans are confusing by design.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">There\u2019s a trail mix of various health plans from good plans to many junk plans.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">From HMOs, PPOs, EPOs, POS, HDHPs, Medicare, Medicaid etc.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You get what you pay for &#8211; the more \u201caffordable\u201d, the more \u201cadvantage\u201d, the more \u201centitled\u201d the less you get in real coverage.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans also come in several tiers and with \u201cpreferred\u201d drug lists.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Most healthcare consumers have no idea what sort of plan they have been sold.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans are in the business of making money and not improving health.\u00a0<\/span><\/li>\n<\/ul>\n<p><b>HSA (Health Savings Accounts).\u00a0<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">HSAs are useful with HDHPs (High Deductible Health Plans).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Both you and your employer make contributions.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You have control of your HSA healthcare dollars for routine care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You budget and manage healthcare spending and shop for prices.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The combination of shopping for prices and making healthy lifestyle choices can save you money.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You can invest this HSA money as you do for your 401(k) and earnings will compound tax free.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">When you retire leftover HSA money is yours to use anyway you want.<\/span><\/li>\n<\/ul>\n<p><b>Prescription drug coverage is broken.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Most prescription drugs and generics are manufactured overseas and often, without strict oversight for quality.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans have \u201cpreferred\u201d lists of drugs &#8211; many drugs bypass quality control mechanisms once imported and distributed in the U.S.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans use PBMs (pharmacy benefit managers) as middlemen who profit from manipulating drug prices at patient expense.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Many costly prescription drugs have marginal if any real patient benefits.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Many drugs should not require burdensome and costly prescriptions &#8211; patients could save money if many more drugs were OTC (over-the-counter).\u00a0<\/span><\/li>\n<\/ul>\n<p><b>Health plans control testing and treatment.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans often deny payments for new and innovative tests and treatments claiming they are \u201cexperimental\u201d.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans commonly authorize treatments identified as \u201cstandard-of-care\u201d or \u201cstandard practice\u201d although these treatments may not have been scientifically proven to be safe and effective.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">John Ioannidis MD, has established clearly that, \u201cmost published research findings are false\u201d because they fail to provide irrefutable and reproducible data.<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.0020124\"><span style=\"font-weight: 400;\">https:\/\/journals.plos.org\/plosmedicine\/article?id=10.1371\/journal.pmed.0020124<\/span><\/a><\/p>\n<p><b>Is health insurance a benefit?<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health insurance plans can make you a target.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Both patients and doctors understand someone else is paying for \u201ccare\u201d.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans create barriers for patients by controlling or denying access to care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plans create endless barriers for doctors trying to deliver care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Health plan providers are not incentivised towards prevention and wellbeing.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">There\u2019s no evidence that health insurance plans have improved overall health.<\/span><\/li>\n<\/ul>\n<p><b>What can be done to fix the broken healthcare system?<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Save money and stop paying for insurance to cover routine care needs.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Get high-deductible plans to cover only unlikely catastrophic illnesses and shop and pay for routine healthcare needs.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take back control of your healthcare &#8211; you decide who you want to see or what you want done.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stop letting non-medical intermediaries working for health plans limit or deny your care.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Healthcare consumers shop and pay for cosmetic, weight-loss and infertility care as they are not usually covered by health plans &#8211; patients understand these healthcare arenas and market forces here have stabilized or lowered costs. Free market forces for routine healthcare will do the same.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Visit <\/span><a href=\"https:\/\/healthdrum.com\"><span style=\"font-weight: 400;\">www.HEALTHdrum.com<\/span><\/a><span style=\"font-weight: 400;\"> Come join our healthcare community and discover how consumer-directed care and <\/span><b>self pay for routine care<\/b><span style=\"font-weight: 400;\"> can save you a bundle of money and put healthcare control back in your hands.<\/span><\/p>\n<p><b>Read more.<\/b><br \/>\n<a href=\"https:\/\/theconversation.com\/why-insurance-companies-control-your-medical-care-62540\"><span style=\"font-weight: 400;\">https:\/\/theconversation.com\/why-insurance-companies-control-your-medical-care-62540<\/span><\/a><\/p>\n<p style=\"text-align: center;\">Written by HEALTHdrum<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Healthcare is a terminal illness for America\u2019s governments and businesses &#8211; Clayton Christensen, \u201cThe Innovator\u2019s Prescription\u201d.\u00a0 Health insurance for catastrophic care makes sense. Health insurance emerged in the 1920s and makes sense to hedge against the cost of unlikely hospital care for a financially catastrophic illness. Health insurance for routine care does not make sense. [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":3941,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[21],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Health Insurance Sickens Healthcare | HEALTHdrum<\/title>\n<meta name=\"description\" content=\"Health insurance sickens healthcare because of rising\u00a0costs.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/healthdrum.com\/blog\/health-insurance-sickens-healthcare\/\" \/>\n<meta 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Subsequently, he completed fellowship training in Pediatric and Adult Reconstructive Urology at the Eastern Virginia Medical School in Norfolk, Virginia. During his time there he also undertook NIH sponsored, pioneering research on \u201cUrinary Bladder Reinnervation\u201d earning him the honor of a Masters of Surgery Diploma through the University of Otago, New Zealand. Dr Vorstman returned to Miami to become a board-certified faculty member in the department of urology, Jackson Memorial Hospital, University of Miami. Eventually, he left academic practice, moved north to Coral Springs and established Florida Urological Associates pa (www.urologyweb.com) in 1987. Dr. Vorstman is passionate about consumer-directed healthcare and helping men diagnosed with prostate cancer navigate the minefield of prostate cancer misinformation. After retiring and leaving colleagues to continue the urology practice, he became founder and CEO of a healthcare platform that connects buyers and sellers of routine, cash pay healthcare services - www.HEALTHdrum.com\/ Through this platform he also enables colleagues to reclaim their profession from health industry exploitation. Partial bibliography https:\/\/ascopost.com\/issues\/june-10-2016\/prostate-cancer-opinions-vary-on-gleason-scores-and-surgery\/ https:\/\/ascopost.com\/issues\/november-25-2020\/a-urologic-surgeon-assesses-the-current-state-of-prostate-cancer\/ https:\/\/www.medscape.com\/viewarticle\/945928 https:\/\/urologyweb.com\/robotic-deception-prostate-cancer-hoax-p-5\/ https:\/\/bvorstman.medium.com\/prostate-cancer-treatment-deception-and-lies-30e23f17b749 https:\/\/healthdrum.com\/blog\/the-gleason-6-prostate-cancer\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Health Insurance Sickens Healthcare | HEALTHdrum","description":"Health insurance sickens healthcare because of 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Subsequently, he completed fellowship training in Pediatric and Adult Reconstructive Urology at the Eastern Virginia Medical School in Norfolk, Virginia. During his time there he also undertook NIH sponsored, pioneering research on \u201cUrinary Bladder Reinnervation\u201d earning him the honor of a Masters of Surgery Diploma through the University of Otago, New Zealand. Dr Vorstman returned to Miami to become a board-certified faculty member in the department of urology, Jackson Memorial Hospital, University of Miami. Eventually, he left academic practice, moved north to Coral Springs and established Florida Urological Associates pa (www.urologyweb.com) in 1987. Dr. Vorstman is passionate about consumer-directed healthcare and helping men diagnosed with prostate cancer navigate the minefield of prostate cancer misinformation. After retiring and leaving colleagues to continue the urology practice, he became founder and CEO of a healthcare platform that connects buyers and sellers of routine, cash pay healthcare services - www.HEALTHdrum.com\/ Through this platform he also enables colleagues to reclaim their profession from health industry exploitation. Partial bibliography https:\/\/ascopost.com\/issues\/june-10-2016\/prostate-cancer-opinions-vary-on-gleason-scores-and-surgery\/ https:\/\/ascopost.com\/issues\/november-25-2020\/a-urologic-surgeon-assesses-the-current-state-of-prostate-cancer\/ https:\/\/www.medscape.com\/viewarticle\/945928 https:\/\/urologyweb.com\/robotic-deception-prostate-cancer-hoax-p-5\/ https:\/\/bvorstman.medium.com\/prostate-cancer-treatment-deception-and-lies-30e23f17b749 https:\/\/healthdrum.com\/blog\/the-gleason-6-prostate-cancer\/"}]}},"_links":{"self":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3174"}],"collection":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/comments?post=3174"}],"version-history":[{"count":16,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3174\/revisions"}],"predecessor-version":[{"id":3899,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/posts\/3174\/revisions\/3899"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/media\/3941"}],"wp:attachment":[{"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/media?parent=3174"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/categories?post=3174"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthdrum.com\/blog\/wp-json\/wp\/v2\/tags?post=3174"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}