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It’s Time to Cut Healthcare Glut

The $3 trillion healthcare industry continues to crush the middle class and destroy the practice of medicine. Americans are paying more than ever and still struggle to access care.

What drives the cost of care in America today is the lack of transparency, administrative glut, overregulation, and ongoing consolidation. The time is now to expose and confront the profiteering special interests behind these four cost drivers.

Obtaining coverage gives relief as costs rise, yet keeps costs hidden and high. Our third-party payment system has obscured patients and physicians alike from knowing the cost of healthcare encounters.

As coverage has increased, without transparency of cost, large hospital systems, pharmaceutical middlemen (PBMs), and the insurance companies who are tied to both hospitals and PBM have been quietly profiting. These corporate giants have no motivation to offer transparency and discounts. Costs remain deliberately hidden from patients until care is received. What lawmaker or CEO would take a flight without knowing the destination or the cost until deplaning?

In addition, the insurers and hospitals work together, with hospitals accepting a small and differing percentage of their charge-master price from different insurers and even among different carriers. Unfortunate patients, whose insurance company denies a service, those who are out of network, or those who lack insurance are stuck with the entire, exorbitant bill.

Profiteers have hijacked the system at the expense of the American people, and now have an undue control over the system. And they are growing like a cancer.

The number of healthcare administrators grew by more than 3,000 percent between 1970 and 2010. In comparison, the growth of physicians during the same time was 200 percent. Concurrently, spending on healthcare increased by 2,300 percent. Is there any other conclusion than to tie rising costs to administrative glut? From 2010 to 2014, over a million more healthcare administrative jobs were created, largely to manage the regulations that our government has put in place. Will those administrators meet you or your loved one in the ER to handle your chest pain? It’s past time to cut the glut.

Administrative glut has led us to medicine’s mergers, creating huge hospital systems, that are adding to expense for all consumers. In regions of our nation with hospital monopolies, patients have no choice, and prices are as much as 1,000 percent higher than in places with multiple hospitals.

Americans are paying more than ever for coverage that limits their choices and doesn’t always provide them access to care. The bloated bureaucratic special interests must be unveiled for America to forge sustainable solutions.

No easy task, as the drivers of cost spent over 400 million in lobbying in 2018 and will be back knocking on doors. Lawmakers must stand for constituents over corporations.

The time is now to follow healthcare’s money trail, unwind existing laws or enact new laws that demand cost transparency, cut administrative glut, stop consolidation and bring regulatory relief. Your health depends on it.

This article originally appeared on The Intelligencer The Intelligencer and is featured here with author permission.

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Marion Mass, M.D.
Marion Mass, M.D.https://practicingphysician.org/
In 2016, I was privileged to be a co-founder of Practicing Physicians of America (PPA), a true grassroots organization. We have a diverse board, including Brian J. Dixon, M.D., pediatric psychiatrist; Niran S. Al-Agba, M.D., pediatrician; Westby G. Fisher, M.D., cardiologist; and Judith L. Thompson, M.D., general and breast surgeon. With the publication of the position paper, Reducing Cost and Waste in American Medicine: A Physician-Led Roadmap to Patient-Centered Medical Care, for the first Free2Care Physician Symposium in April 2019, groups similar to PPA networked to form the FREE2CARE Coalition, which has since become an umbrella for 30 groups, 8 million citizens, and 70,000 physicians. Many in the coalition now speak, write, and advocate at the state and national levels to advance the agenda articulated in the original position paper. I have no conflicts of interest, have never taken a speaking fee, and serve as a volunteer on my county newspaper’s editorial board and with my county’s health society. Friends and family know my foibles and faux pas best. Sometimes, I’ve been so focused on the task at hand that I’ve run errands in public in my bathrobe—my attire of choice when writing at home.

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