{"id":3373,"date":"2021-07-03T09:00:14","date_gmt":"2021-07-03T09:00:14","guid":{"rendered":"https:\/\/healthdrum.com\/?p=3373"},"modified":"2021-10-12T15:39:35","modified_gmt":"2021-10-12T15:39:35","slug":"how-health-insurances-control-patients-employers-and-doctors","status":"publish","type":"post","link":"https:\/\/healthdrum.com\/blog\/how-health-insurances-control-patients-employers-and-doctors\/","title":{"rendered":"Insurances Controlling Patients, Employers and Doctors"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">The health insurance industry controls patients, employers, and doctors by gaming the business of health benefits. Healthcare is an insurance industry monopoly that through scare tactics and misrepresentations has fooled everyone &#8211; including governments and the AMA (American Medical\u00a0 Association) &#8211; to let them act as middlemen between patients and doctors. A level of control that has become abusive, costly, and failed to improve overall health.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Although health insurance was first designed to cover major or catastrophic care it slowly evolved to cover routine services. Highly unnecessary, the health insurance industry simply shifted costs for routine care to consumers through copays, deductibles, and non-covered services. Along with this prescription came anti-competitive mergers and self-serving healthcare laws that resulted in a massive consolidation of corporate power and erosion of patient, employer, and physician healthcare autonomy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Two-thirds of the $3.6 trillion healthcare market is generally affordable routine office-based or outpatient care. Because the health insurance industry controls this care, billions of dollars are wasted each year on administration services in order for patients, employers, and doctors to play by health insurance rules.<\/span><\/p>\n<p><b>How the health insurance industry controls patients.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Offers health plans that are complex by design and impossible to understand<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Offer a variety of junk health plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Offer confusing tiered plans such as bronze, silver, gold<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Doctor networks with limited choices<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Non-medical intermediaries working for health plans delaying, rationing or denying care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Calling innovative new treatments experimental and routinely denying them<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Creating barriers to access by requiring referrals and authorizations for specialists, tests and treatments<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Make you pay copays, deductibles and for non-covered services while the costly, rule-based health plan fails to kick in<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Giving you endless surprise bills<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Delivering health plan price hikes every year<\/span><\/li>\n<\/ul>\n<p><b>How the health insurance industry controls employers.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tiered pricing that is burdensome for small business employers<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Confusing plan options<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Held to insurance-based pricing and rules<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Healthcare laws necessitate administrative and human resource costs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pay more for health plans than employees commonly use in services<\/span><\/li>\n<\/ul>\n<p><b>How the health insurance industry controls doctors.<\/b><\/p>\n<ul style=\"line-height: 1.6;\">\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Take it or leave it contracts<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Created restrictive networks<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Endless burdensome and self-serving rules<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severely discounted and delayed payments<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Require endless hours pursuing authorizations from health plan non-medical intermediaries whose sole purpose is to delay, ration or deny care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Requiring malpractice insurance that mostly invites frivolous lawsuits and quick settlements<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tiered (and discriminatory) payments so doctors treating the same disease in different States or, within States get paid differently<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tiered payments so different specialists treating the same disease are paid differently<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bundling the costs for more than one procedure needed at time of surgery to one payment that is considerably less than if each had been provided separately<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Require burdensome and expensive electronic medical records system<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Require specialist office personnel to deal with complex medical coding and claims filing systems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ability to claw back payments made within an 18 month period (despite authorizations)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">By gaming, the business of healthcare, the health insurance industry has increased provider practice overhead to 70% and increased the level of physician burnout<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It is simply amazing that the health insurance industry can hold patients, employers and doctors to ransom, profit at their expense and fail to improve overall health.<\/span><\/p>\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 <\/span><b>consumer-directed, self-pay care<\/b><span style=\"font-weight: 400;\"> can save you a bundle of money and put healthcare control back in your hands.\u00a0<\/span><\/p>\n<p><b>Read more.<\/b><\/p>\n<p><a href=\"https:\/\/healthdrum.com\/blog\/how-employers-can-control-health-insurance-costs\/\"><span style=\"font-weight: 400;\">https:\/\/healthdrum.com\/blog\/how-employers-can-control-health-insurance-costs\/<\/span><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">\u00a0Written by HEALTHdrum<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The health insurance industry controls patients, employers, and doctors by gaming the business of health benefits. Healthcare is an insurance industry monopoly that through scare tactics and misrepresentations has fooled everyone &#8211; including governments and the AMA (American Medical\u00a0 Association) &#8211; to let them act as middlemen between patients and doctors. A level of control [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":3376,"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>Insurances Controlling Patients, Employers and Doctors | HEALTHdrum<\/title>\n<meta name=\"description\" content=\"Discover how health insurance plans control consumers, employers and\u00a0providers with HEALTHdrum.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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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. 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