Our stupid, stupid health care system and the people who run it

Following is the text of a letter from a doctor to the editor of the Wall Street Journal. The letter supports the notion of high-deductibles to keep people from spending on health care.

The “bronze” and “sil­ver” plans aren’t ex­pen­sive to purchase but come with large de­ductibles, $3,000 to $6,000. This means that our pa­tients are pay­ing for much of their care out of pocket. We are fi­nally hear­ing from our pa­tients ques­tions like, “Do I re­ally need to spend $2,000 for an MRI to eval­u­ate my low back pain?” For most of our pa­tients, es­pe­cially those on first-dol­lar cov­er­age, the ques­tion be­fore high deductibles be­came fash­ion­able was, “Why can’t I get my MRI to­day?” Ex­pand­ing the ACA de­ductibles to all health insur­ance in our coun­try would very greatly re­duce the to­tal cost of med­ical care.

Why is this stupid? Well, the first question to be asked should be, “Why does that MRI cost $2,000? But the real issue is, if the patient can save money by not having the MRI with no adverse consequence, why was the MRI ordered in the first place?

“Why can’t I have the MRI today?” Isn’t that a reasonable question given a person is in pain and his doctor recommended the MRI as an appropriate course of action?

Are we then to conclude the MRI as not really necessary in the first place? Was the doctor practicing defensive medicine, does he have a financial interest in the MRI facility, is he just not the best doctor?

So, are we now saying a financial burden on patients is the best way to assure we are all getting quality health care? Stupid, stupid system as are the people trying to sell you changes😳

Oh, by the way, about that “bronze” and “sil­ver” plans aren’t ex­pen­sive to purchase,” I guess he means because someone else is often paying most of the premium. Here is a silver plan in NJ for a couple both age 40 earning $40,000 a year. The actual annual premium is $8,040 (and this is a non-profit consumer run plan). Also note the co-pays and co-insurance.