By Donna Smith
 
Patients in the United States have known for a long time that they are not the decision makers in matters related to their personal health and well-being.  Just as for-profit corporate interests control elections, candidates, public officials, policies and enforcement, for-profit health insurance companies control healthcare delivery.  So when a recent report came out about insurance companies buying up physician groups and providers in increasing numbers, I wasn’t very surprised. 

Left to the for-profit financial services corporations known as health insurance companies, more firmly entrenched market-based healthcare delivery will thrive on doctors doing exactly what shareholders need them to do as direct employees.

See the report here.
 
A colleague pointed out to me that this really isn’t too much of a news flash, and that doctors have been working for their keep from the for-profit insurance companies for some time.  I suppose it’s just shocking to my sensibilities to now need to ask directly of my doctors and other providers, “Who owns this practice or facility? CIGNA?  United Health Care?”  Knowing who is signing the paychecks is critical to knowing whose interests are being protected and enhanced.  
 
But drill deeper into this business strategy.  From the article:  “The model poses a natural threat to providers, particularly hospitals. OptumHealth, UnitedHealth's subsidiary, has said its physician networks serve all players in a health system, including rival health plans with policyholders who use the same physicians…  Primary care physicians are already in high-demand, and by acquiring them in certain markets, insurers could potentially wrest control of entire health systems by influencing referrals - whether that is an explicit intention or not.”
 
Exactly how will a Blue Cross covered patient fare at a Humana owned clinic or doctors’ group?  Will one insurance giant negotiate with another for contracted services offered by the others’ doctors?  It all seems a tad incestuous to me somehow.  
 
So, there we go.  All the fears expressed about government takeover of healthcare if we moved to a progressively financed, single standard of high quality care for all – an improved and enhanced Medicare for all system – can now be released in favor of the takeover actually occurring.
 
Health insurance giants only make money if high enough premiums come in from enough people, if medical losses/claims payments are kept at a minimum, if investments are offering a strong return and regulatory interference and interruptions of all of these are limited.  It’s about the money.  It’s about the profit.  It is not about the patients.  It is not about the policy holders.  
 
So the next time you get ready to sign those forms at the front desk of your doctor’s office or the admissions cubicle at the hospital or clinic – you know, the acceptance of financial responsibility and risk and the assignment of benefits forms that relinquish most of your legal protections – make sure to ask for full disclosure of who is calling the shots for the practice or provider.
 
Call it your own “Who’s My Doctor’s Daddy?” form.   It is critical to your health and mine that they all know that we know what is going on here.  And until we can make this awful system accountable to patient needs and not greed, we’d better beware.