What a Mess

BQ, MR and HN were here yesterday. All three of them have complaints about their physicians - either past or current. BS was here yesterday and he has a lot of physican friends. He is a businessman and spoke extensively (I ran late) about health care finance. Many physicians are leaving medicine or are frustrated. The economics are very challenging. I spoke with a physician friend yesterday who has stopped going to hospitals entirely and has stopped taking any insurance other than medicare. He is planning to stop taking medicare as well. He also has no malpractice insurance. Several physicians in this area no longer have malpractice insurance. Personally, it seems to me that it is insane to have for-profit health insurance plans. It should be illegal. All insurance plans need to be mutual companies, owned by the insured. Right now they are in a bind. They are supposed to make profits for the shareholders. The shareholders own the company. Physicians are now actually called "insurance implementers". We became "health care providers" a while ago. Some people now call us "prescribers". These names allow people to see us as cost centers or profit centers. This treatment changes our self-perceptions and behaviors. Our overall quality is decreasing. Patient satisfaction is decreasing. The democrats want universal coverage through some governmental agency. McCain wants increased competition. Unfortunately, no one wants to tackle the fundamental flaw in for-profit insurance. No one wants to tackle the fundamental flaw in having "consumers" (patients) use services that they don't pay for. No one wants to tackle the incentives that "providers" (Physicians) have to increase "utilization" (health care provided) including fear of malpractice and increased revenues. So nothing that the government is planning is going to help anything in the near future. Physician groups just want to protect their incomes. Patient groups just want to continue to pursue unlimited care without any financial incentives. Insurance companies just want to maximize their profits by decreasing the amount of health care provided while increasing premiums. Politicians just want to pander to the electorate.
It's quite a show. If it were a movie, it would be one of those suspense type of things where it just doesn't seem like things are going to end well. It's a little like "The Firm", I suppose. I wonder where this is all going to end up.