As humans, we revel in our relationships. We are pack animals. We need love, connection, and trust when it comes to those we are closest to and love the most. We long for companionship, rely on others for the skills that they have and we lack, and our tribal nature has been essential for our survival over so many years.
This is why I shake my head in confusion when I see a fellow human in a toxic relationship, being treated poorly, used, or taken advantage of. The confusion isn’t with one human being mistreating another, as that has likely occurred since the beginning of time. What baffles me is when one on the receiving end of this abuse remains in that situation.
What saddens me most, actually angers me, is when the one taking that abuse is actually stuck. They have to remain because they literally have no alternatives. That is the scariest of scenarios, because even when that person recognizes their rough situation and would get out if possible, they simply cannot.
I think this is why I have such disdain for insurance companies and the pharmaceutical industry. Over the past twenty-five years in private practice, I have witnessed too much abuse on behalf of both of those behemoth industries. I have watched in awe as these two industries have displayed the most despicable behaviors. And what’s worse, is they don’t even hide it.
Think about this… when you go to a doctor, you essentially enter into a relationship with unspoken assumptions. The doctor agrees to do his or her best job to help resolve whatever condition ails you. They utilize their expertise, experience, and caring to do their best for you. In return, you agree to pay that doctor for their time and service. This is not much different than most business transactions. Two people come together, exchanging one thing for another, as agreed upon.
But in healthcare, there is a third party… the insurance companies. Here is a group that has injected themselves into the system, disrupting care, dictating the care that doctors provide, and making all decisions based on one single thing… money. While the relationship between doctor and patient can be healthy and strong, the involvement of insurance is very dysfunctional. Why is it dysfunctional? Because they don’t care about you, and they don’t care about the doctor. They are making all decisions based on trying to pay out as little as possible. Therefore, your best interest is something they don’t even consider.
I am sure by now you have had the experience when your doctor knows you need a test, but in order to have that test done, the insurance company dictates that you must go through other procedures first. Maybe the doctor has serious concerns about your condition and knows an MRI is the best diagnostic tool available, yet the insurance company will not pay for an MRI until you complete six weeks of physical therapy. The doctor knows that the therapy (in this scenario) will not help, and that an MRI is imperative. Yet he or she cannot order that test… per the insurance company. The insurance company does not know you, does not know the doctor, and likely knows very little, or nothing, about your case. It’s scary, unethical, and has disrupted quality healthcare.
My son was recently in a car accident where he was rear-ended, and our car was totaled. The accident was not our fault. The man that caused the accident seemed to be a decent person, but his insurance company is involved and behaving very poorly. The man has paid for insurance, the insurance company has promised to provide a specific service, and now that the service is needed, they refuse to act honorably. Are they concerned about my son’s well-being? No. Are they concerned about the fact that I am without a vehicle? No. Are they offering a reasonable amount of money for me to replace that vehicle? Of course not. Why? Because they are making their decisions based on that one thing… how little they can pay out. That’s dysfunctional.
Their behaviors, if performed by any other industry, would be deemed illegal. People would go to jail. But somehow, they have managed to create a system where they can take in more and more money, while paying out less and less… and do so at the expense and well-being of the very people that have hired them.
What makes it even worse is that we have no choice. We are stuck. The abuse is unavoidable. And I know that insurance plays a positive role in a lot of instances (I had a rental property burn down and am very thankful I had good insurance), but you must at least be aware that when an insurance company is involved, especially with your healthcare, your best interest is NOT their primary concern.
I pay for a lot of stuff out of pocket because I cannot rely on my insurance company. Some believe that what the insurance company pays for is what they need. Nope! They pay for what saves them the most money. So, don’t let your health suffer and become jeopardized by putting it in the hands of the insurance company. The reason so many doctors are opting out of the insurance game, and going to a cash-based practice, is because they are sick and tired of the insurance company dictating care.
While you cannot escape the insurance game, understanding that it is dysfunctional is a good place to start. Shame on the greed and lack of compassion that these industries exhibit. Be sure to see it for what it is. They don’t care about you… they don’t care about me… they care about making more money. And this profit-driven focus comes at the expense of our well-being. I’ll share some thoughts about the pharmaceutical industry next week (in Part 2).