16 September 2009

An End to the Insurance Monopoly


Edisto Island, S.C.

I tend to keep things light on this blog but as anyone in working with the public in health care I clearly see the need for reform. This is a reprint of Dr. Marshall Newton's letter to the Editor in today's paper. He is a real doctor, trying to take care of real patients. Dr. Newton is the kind of doctor who takes care of families, hugs his patients and goes on mission trips. He is a doctor whose opinion we should consider.
Time to put an end to insurance monopoly
Wednesday, September 16, 2009

As a family medicine physician for 12 years in Charleston, deep in the trenches of primary care medicine, I find it hard to sit quietly by and listen to so many uninformed opinions about health care reform. Please know this, this system is very broken. Most of us have a for-profit insurance company in between us and our physician, often interfering in the plan of care in order to maximize profits. I see this every day.

About four months ago, a major insurance company in the Charleston market sent letters to physicians like myself stating that now a review board would have to agree before any significant radiology test would be allowed. Can you believe that? Medicare, the socialized medicine option for the disabled and citizens over age 65, has never attempted to block radiology studies that I've ordered. Since that day, just about every CT scan we try to order gets scrutinized and often blocked by this insurance company.

Ask my 58-year-old patient with a long smoking history with a 30-pound weight loss in three months for an unknown reason what he thinks about his CT scans being denied multiple times until approved at the last minute after lots of yelling and screaming. This is becoming the norm now and this is what some people are trying so hard to protect? Insurance companies are even asking for prior authorizations on generic medicines that I know can be purchased for $12 at the local pharmacy. Ridiculous. They need to get out of the way as neither the patient nor the doctor invited them to get between us.

There is a lot right about our system but let's correct the wrong while protecting what is right. Democrats and Republicans agree on the following major issues: No discrimination for pre-existing conditions, no huge out-of-pocket expenses/deductibles/co-pays, cover preventative services, no dropping of coverage for the seriously ill, no gender discrimination, no annual or lifetime caps, guaranteed insurance renewal.

Let's change the well-documented fact that two out of three bankruptcies are from medical bills. In this great country of ours, this is not right. And can you believe that three-fourths of the people who go bankrupt from medical bills had insurance? That shows the problem of being under-insured.

So let's find a way to get more competition in the insurance market so we can all shop around for choices. One thing is for sure, you can't right now. Most major health care markets have one insurance company that monopolizes the market. That is un-American. Let's change that. If the private sector cannot generate the competition, then perhaps a public health insurance option or co-ops are the only solution for now.

Let's make sure that some way, somehow, everyone can get affordable health insurance. And let's find a way to lower costs of medicines. Why can my patients get medicines for up to 75 percent less simply by mailing my prescription to a Canadian pharmacy? Let's allow Medicare Part D to be able to negotiate with these pharmaceutical companies the way the Veterans Administration office so successfully did.

It is time to get mad and demand action. It can be done.

E. MARSHALL NEWTON, M.D.
Tobias Gadsden Boulevard
Charleston