How Insurance Companies Meddle in Your Healthcare

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Video podcast about insurance companies making medical decisions for doctors!

Your Insurance company is in business to make money, not to take care of you! That is not what they tell you in their ads, but it is true!

This week’s podcast is not the one we planned to present. We got side-tracked by an encounter we had with an insurance company who refused to pay for a medication that is both cheap and is used throughout a lifetime, once it is used it should be continued. This week I received a letter from an insurance company informing me that a chronic medication — a hormone replacement for thyroid — I prescribed for several of my patients should not be given to elderly patients. Because the patient got a year older, the thyroid medication he had taken for a decade was considered not appropriate for his age even though he does well on it and there is no substitute for it. The letter demanded that I respond with a justification of my actions, that I transfer the patient onto a drug that the insurance company did accept, and that I cease giving these patients the drug that I had prescribed. This is wrong on many levels, but happens every day in the world of medicine. This is your insurance company playing doctor. They are not licensed or qualified to do that, and it is improper and dangerous.

Moreover, this demand should not have been sent to me because I have no contracts with insurance companies and do not take insurance reimbursement for my work with my patients, therefore, have no relationship with them. My relationship is with my patients only.

So this begs the question, why are they contacting me and instructing me how to practice medicine?

  1. The insurance company is not licensed to practice medicine; they have no legal liability to the patient for the medical decisions I make. I spent eight years training to be a doctor and they are demanding that I follow their instructions. Insurance companies have no medical education. So why are they getting involved?
  2. The patients in question did not receive any notification that they were injecting themselves in their medical care. These patients are paying for my medical care with the full knowledge that my work is not covered by their insurance companies. They are not asking the companies to pay any portion of the cost.

Why then do the companies believe that they should get involved in communicating with me and instructing me how to practice medicine as I care for these individuals with their full knowledge and informed consent to the treatment I provide? What legitimate role do the insurance companies have here? How can they insert themselves between me and my patient without the patient’s knowledge and permission?

As you can see, these are hot button issues that occur in doctor’s offices all over America. Why are these commercial enterprises — money-making machines — allowed to manage the medical care of patients and interfere with the treatment of doctors who are medically trained, licensed, and liable physicians? By bullying physicians they interject a new medication when a change is not needed. It happens all the time when they make the copay too expensive for the patient, or require lengthy phone conversations between the doctor and the insurance company to get a medication approved. What right do they have and what role do they play in the management of medical decisions?

Here’s an example: Your neighbor is having trouble with his employer and is negotiating a contract with them. You are not involved but the employer calls you to ask you to go over and pressure your neighbor to accept the contract as is. It is not your business; it is invasive and unethical for them to do that.

As America struggles with deciding the future of health care, I want to strongly urge consumers to become involved in the fight. Private medical practices all over the nation experience the interference of insurance companies in the very private doctor patient relationship. These pressures from the money-changers is affecting the health outcomes patients. Always remember the insurance company has only one objective: maximize profit. Next time you have your treatment plan changed by your insurance company, ask yourself if we can afford to continue to let these companies insert themselves in your medical treatment.