Profits are getting in the way of healthcare

On the cusp of open enrollment season, consumers are concerned about the high costs impacting their access to healthcare, increasing medical debt, and the lack of mental health coverage, according to a new nationwide survey by Gravie and Wakefield Research. As long as profits are a priority, patients will continue to suffer.

The data reveals that a staggering 86% of consumers are concerned that their health benefits will not cover a portion or all of their exams, treatments, or procedures for this year. Additionally, 71% of consumers stated that their health plan does not cover mental health, and two-thirds of consumers are concerned that their current mental health coverage does not address the needs of themselves and their families. 

Other key findings from the survey data include the following:

  • Over one-third of consumers find figuring out what is covered under their eemployer’shealth plan more stressful than their current job.
  • 59% of consumers experienced consequences within the last year due to obstacles or delays in scheduling medical exams, treatments, or procedures, including increased mental stress, using personal time at work, increased pain, inability to take care of a family member, losing their job, etc.
  • 52% view the process of seeking a referral as an unnecessary hurdle delaying the care they need.
  • 65% of consumers experience difficulty receiving a referral to a specialist for a treatment or procedure.
  • Over half of consumers have delayed or canceled exams, treatment, or procedures due to the high insurance cost over the last year.

A poll of 600 physicians shows frustration over insurer policies and delays that doctors say could beleaveatients in prolonged pain.

Researchers with Aimed Alliance, a non-profit that seeks to protect and enhance the rights of healthcare consumers and providers, say that doctors are so fed up with the constant headaches caused by insurers that two-thirds would recommend against pursuing a career in medicine. Nearly half (48%) are considering a career change altogether.

For the study, the organization polled 600 physicians in the U.S. practicing either family medicine, internal medicine, pediatrics, or obstetrics/gynecology. The group sought to understand how insurance policies impact primary care physicians, their practices, and their patients daily. They also wanted to get a better understanding of mental health issues among providers, as well as the causes behind the national provider shortage.

Researchers found that physicians don’t think very highly of health insurance companies and believe they’re putting patients at risk with policies such as prior authorizations ahead of filling prescriptions. In fact, 87% of doctors say patients’ conditions have worsened because of such red-tape regulations, and 83% worry the patients will suffer prolonged pain.

Prior authorizations are especially bothersome for doctors. More than nine in ten (91%) of those surveyed think the policy delays necessary care for patients. Similarly, the same number of doctors agree insurers engage in “on-medical switching,” which forces patients to take less costly — but potentially less effective — medicines.

Such policies are stressing many physicians out. Thirty-seven percent say insurance issues cause half or more of their daily stress, and 65% feel they face more significant legal risks because of decisions made by insurers. The vast majority (85%) are left frustrated by such issues, and many admit to taking their anger and emotions out on their staff and even family members.

The survey showed that 77% of doctors have had to hire more staffers to handle the heavier administrative load of insurance work. Ninety-percent says they have less time to spend with patients because of the burden.

UnitedHealth, the largest insurer in the U.S., net earnings have surged since 2015, reaching $17.7 billion last year as their business has rapidly expanded into other healthcare sectors. Last year, UnitedHealth returned more than $5 billion in dividends to shareholders, and other companies have done the same.

Profits at health insurers

ANY business aims to maximize profits, but in healthcare, iit’scoming at the expense of patients.