Has the Health Care Industry Become One Huge Money-Making Scam?

According to a report published by the researchers at The Dartmouth Institute for Health Policy & Clinical Practice earlier this year, evidence-based research has declined in the U.S. health-care system and corporate greed has degraded the entire system.

Health care is a prominent global industry, a key responsibility of the government as well as businesses, but more than that, it is an essential human right. However, certain financial forces such as insurance companies, hospital networks, and regulatory groups are beginning to corrupt care and undermine the bond between doctors and patients.

Pay-For-Performance Medical Contracts

Pay-for-performance schemes are widely used by private payers and Medicare in the U.S. to improve the quality of health care and reduce costs. However, there’s little evidence whether or not these criteria actually improve quality or do any good to patients.

As per such policies, physicians are directed to meet stringent metrics for testing and treatment. But these metrics don’t take into account the individual characteristics and preferences of the patient or differing expert opinions on optimal practice. Instead, they’re generic and population-based, which is why they are ineffective when it comes to improving patient outcomes.

Perhaps this is the reason why the report by the Commonwealth Fund shows the U.S. health-care system is the most expensive in the world. However, when it comes to health outcomes, the industry performs worse than 11 other industrialized nations in terms of health access, efficiency, and equity.
 
Physicians who achieve their targets are not only rewarded with a bonus from the insurer, but are also given high ratings on insurer websites. Physicians who deviate from such metrics, on the other hand, are financially penalized through lower payments and can suffer from poor ratings on healthcare review sites.

Insurers Dictating Medications

Playing the insurance game has become an uphill climb for the patient.

WellPoint, one of the largest American health insurance companies, recently outlined treatment pathways for cancer. The company further announced that it would pay physicians an incentive of $350 per month for every patient treated as per the designated treatment protocol.

WellPoint is just one among the several insurers who are offering a positive financial incentive directly to physicians for using specific medications. This is leading to a scenario wherein patients may not get the health treatments that are best for them. Instead, they may get those which the insurance companies think might be right for them.

Medical Research Influenced by Financial Incentives

According to the report produced by The Dartmouth Institute for Health Policy & Clinical Practice in 2015, the pharmaceutical industry has influenced medical research in its favor by selective reporting, targeted educational efforts, and incentivizing prescriber behavior that influences how medicine is practiced.

The report further emphasizes how finance is playing a far more important role than rigorous scientific process in medical research at present. Drug trials that show positive results are quickly published and promoted, while the results of trials that do not show beneficial effects remain unpublished or are suppressed by the sponsors.

Suppressed data related to ineffective drugs and devices may endanger patients who are subjects in clinical trials or who may subsequently use them for treatment.

Industry-supported trials dominate the medical field, with an almost exclusive focus on health problems that expand the market share.
 
Outrageously Expensive Medical Bills

According to the financial advice company NerdWallet, medical bankruptcy is the most prevalent cause of personal bankruptcy in the U.S. Americans pay three times more for medical debt than bank and credit-card debts combined. Moreover, it’s important to note that those who went bankrupt because of medical bills were not those without insurance. In fact, three-fourths of those people who become bankrupt due to medical bills were covered by some form of health care coverage.

The study also concluded that 63 percent Americans have received medical bills that were more than what they expected to pay. Worst of all - several bills were a result of hospital errors and almost half of Medicare insurance claims contain billing mistakes.
 
These practices are making it clear that in today’s healthcare system, power belongs to insurers and regulators who control money, and not doctors or patients. Health care is a more profit-driven industry than ever before; where patients’ interests are of little or no significance.

George Catlin founded Withdrawal Ease due to his own struggle with opiate dependency following a surgical procedure in 2007. He has written The Opiate Withdrawal Survival Guide and created a nutritional supplement system specifically formulated to reduce the acuity of opiate withdrawal. Check out his about page on his blog for the whole story.