By Marion Mass
Health care in America has been sick for decades, but the acuity of the illness has progressed rapidly in recently years.
Sadly, the Affordable Care Act doubled down on the failing system and has put families at a breaking point. No one can argue with the affordability goal but, while millions of people now have access to insurance, they lack what's more important: access to care.
The law accelerated the financial chokehold on the middle class with skyrocketing premiums and deductibles, intolerable co-pays, and fewer health-care choices. As for small businesses, those purchasing insurance for their employees are paying higher taxes and premiums, too. And patients get less time with physicians, who are pushed by hospitals and insurance companies to see more people daily. I see or hear about these problems every day.
How did all of this happen?
Over the past 40 years, there have been a cadre of players who eyed up the juicy health-care pie and jockeyed effectively for their piece. They have been gorging on that pie with little regard to the cost to the patient. Among the top lobbyist groups in America, four are health-care related: Big insurance, big pharma, the American Hospital Association, and the American Medical Association.
The result of all this lobbying can be summed up in two words: administrative glut.
Since 1970, the number of physicians practicing in America has grown by roughly 200 percent. Administrators have grown by more than 3,000 percent. This is the number-one driver behind per capita health-care spending.
Sadly, my profession is complicit in several ways.
Practicing physicians have left our profession's advocacy to physicians who have become professional politicians. Their home is the AMA, whose membership has dwindled from 75 percent in the 1950s to roughly 15 percent of practicing physicians today.
Where does the AMA get its lobbying money? From big insurance, which owns the coding system that every doc has to use in order to be reimbursed by insurance. Even though it's in doctors' best interests to rein in the rise of health insurance at the expense of health care, the AMA is likely unwilling to do so because it depends on the insurance industry for money.
There is hope, however. Dozens of groups of physicians have been collaborating and devoting their free time to real reform. Aligned together, we have a stronger voice to advocate for our patients, whose suffering we see. This is personal for us, because medicine is personal. You learn that the first time you interview patients and lay your hands on them for examination.
We believe that our profession can advance ways to ensure that all patients have real access to care, and still make it more affordable for most Americans. A reduction in administrative glut and a return to more models of care, specifically a true free market for patients are two components to reduce costs. A great place to start is to look at the basics included in the Health Rosetta Principles (www.healthrosetta.org), a collaborative effort among entrepreneurs and visionaries in the health-care space. A specific, patient-centric plan comes from the Docs4Patient Care Foundation (www.d4pcfoundation.org).
Now it's time for Congress and President Trump to listen to the doctors who have Americans' best interests at heart. Patients need a navigable and easily understood system, where costs stay low and choices abound. That won't happen so long as lawmakers continue listening to the major health-industry lobbyists and the AMA, all of which are complicit in making our health-care system so sick.
We have a chance to bring health back to health care, and benefit millions of patients who have been waiting too long for access to quality care. The question is, will our lawmakers listen to the real experts who know how to make that happen - the physicians and those who don't have a financial stake in ruining health care for everyone else?