According to the author of this article, regarding healthcare access and cost, we have met the enemy and the enemy is us.
For those of us used to the system in the U.S., primary care is often no more than a referral doctor who sends us to an endless stream of other providers, after meeting with us for a brief visit. There is also the walk-in clinic that does not do primary care but is more like a doc you can see when stuff happens and you want fast uncomplicated medical care. Walk-in clinics, some of which do primary care such as Medi merge in Greenbrook are more like a mini Emergency room where you can be seen on weekends and during later hours when your regular doctor may not be available. As always in the US, you are sure to get a bill(s) that often may seem excessive and costs can run amuck.
The British system emphasizes and pays primary care doctors better than the US, but getting to a specialist can be more cumbersome and the system values cost controls. Patients never see a bill and their doctor is reimbursed under a global system designed to contain costs.
It has been said that the system in the US is an expensive mess with middlemen such as insurance companies that promise the world and then restrict your access. In a system like that in Great Britain, the system works by keeping you away from specialists and paying primary care doctors better, who keep you out of harm’s way.
Doctors in both systems are afraid of being sued and do order some tests and perform some actions designed to keep them out of trouble.
The idea of never receiving a medical bill is appealing while your care is just taken care of. The business model in the US of promises of care and then denials of promised care with crazy bills being sent to you is insane. Doctors are leaving private practice in droves due to the inability to get paid appropriately after they were approved for medically necessary care, and then having to hire people to collect it. The practice of high deductibles for care is also insane, as hospitals are being hit with the deductibles and then billing us. The following year, they raise their prices and insurers raise ours. That’s nuts!
What is even more nuts is that hospitals are employing primary care physicians and other specialists to keep everything in-house even when they don’t have the answers.
Sloane Kettering, the well-known cancer hospital, and many others are feeling the changes at hand and are seeing less demand for their services as patients are less willing to travel or as hospital systems are keeping everything in-house. The American system is less about healthcare than about corporations and corporate healthcare. The British system is more about caring for patients, something we have forgotten how to do.
Patients also falsely think that more tests, more procedures, etc are better. The truth is that it’s not and it ends up causing needless suffering and in some cases disfigurement.
There is one more glaring weakness for the medical system in general which is musculoskeletal system care which comprises 55% of the body. All body systems are integrated and should be evaluated and treated holistically. Chiropractic physicians have filled the role of primary care for the musculoskeletal system. While most insurance carriers do offer coverage, patients often will pay out of pocket for this care when their insurers fail to offer adequate networks or have set up artificial roadblocks to care such as recertification or artificially low reimbursements.
In the USA, the 2022 Chiropractic Medicare Modernization act failed to pass in the 2022 session but had gained a remarkable 153 co-sponsors which was a record for any chiropractic legislation. This coming year of 2023 may be the year it finally passes which will level the playing field for doctors of chiropractic who are saving the system money while offering effective and efficient care of musculoskeletal complaints. Patients who rely on chiropractors know that their doctors of chiropractic offer the fastest and safest route to the relief of sciatic pain, back pain, shoulder problems, neck problems, knee problems, and many other complaints. Chiropractic has continued to be endorsed by Optum Health, Harvard Health, Consumer Reports, Bottom Line Personal, and many other sources based on patient satisfaction, safety, and results.
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Check out this article
What’s the Point of a Primary Care Doctor?
They seem to exist entirely to funnel patients to more expensive specialists—but it may be the consumer, not the healthcare industry, who’s really to blame for this, and we’re suffering as a result.
“I still don’t really understand what’s going on with the health system, and I’ve been here nearly five years,” says Alistair, a sports journalist who lives and works in New York City. An American citizen by parentage, but brought up in England, he says he’s only now coming to grips with the risky business of insurance. “In Britain you don’t need to understand it — you just go to a doctor and they treat you and then you go home. But here there’s co-pays, deductibles and all these words. It’s just not nice to have that extra stress when you’re ill.”
For someone who had never once had to pay for treatment, nor so much as glance at a medical bill or insurance form until he was in his 30s, Alistair’s experiences in American doctors’ offices have so far made him wary of physicians’ motives. “You’re always suspicious about over-treatment here,” he sighs. When he saw a dermatologist about a worrying mole, for example, it was recommended he undergo a procedure to have it surgically removed. But it wasn’t until afterwards that his friend, a qualified doctor from Australia (which currently holds the dubious title of the worldwide home of melanoma), told him: “That’s bullshit, in Australia they’d have scraped it off. They’ve completely over-treated you there so they could charge you.”