Date of Award
The American people are struggling to pay for or find good health insurance. Doctors are unable to prescribe them what they actually need. Their insurance might stop paying for the drug that they had been using that was helping them. They might have to try some amount of drugs or treatments before the insurance company will pay for what the doctor has prescribed. Patients might be having to endure more pain for an unnecessary amount of time at the hands of an insurance company. What are the roots of these problems? With the growing complexity and advancing technology, how are all members of the healthcare team navigating this increasingly convoluted insurance marketplace? Can this be fixed? In order to answer these questions, I researched literature and conducted interviews with healthcare professionals. These problems have come from excessive spending, government mandates, exclusive negotiations, and stifled market competition. Doctors and other providers have their hands tied when it comes to providing the best care possible for their patients, their main concern. Doctors are having to settle for not the optimal prescription, see more patients, do more work, combat reduced revenues, and jump through more hoops. There are some things we can do to help fix some of these problems. We can do away with the Medical Loss Ratio laws, improve market competition by doing things like eliminating the state line restrictions to selling health insurance, get practicing physicians more involved in insurance administration, and incentivize successful outcomes.
Crim, Robert Balie, "Exploring Health Insurance Coverage and How it is Affecting Patients and Providers" (2021). Honors Theses. 1857.
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