Dr. Sean Lehmann: For-profit insurance destructive to healthcare

I read with interest Dr. Edward Gray’s column, “A doctor perspective on healthcare.” As a physician in private practice for 17 years and also having a master’s degree in healthcare administration, I feel well situated to offer a rebuttal.

It seems as though Gray blames our medical woes on two major factors: lawyers and government regulation. While neither of these are particularly helpful, Gray ignores the gorilla in the room: private, for-profit insurance.

Our country has tried for decades for the private sector to “find innovative answers” to our healthcare mess. We have tried the Republican way, we have tried the Democrat way. It fails every time because we continue to allow for-profit insurance companies to run the show. There’s a reason why no other country on Earth has a medical system that’s controlled and ran by for-profit insurance: It doesn’t work.

Our current healthcare system is ranked No. 37 by the World Health Organization, mostly due to poor access and high costs. Gray mentions thousands of medical tourists come to the United States for treatment. What he fails to mention is far more leave the United States for treatment abroad, because they can’t afford it here.

For-profit insurance companies typically have an overhead of nearly 20 percent.

Insurance companies are middlemen that don’t provide healthcare and add no value to the system. CEOs make millions of dollars and insurance companies profit to the tune of billions. How do they do this? By raising premiums, co-pays, and deductibles, and denying care. On the other hand, the overhead with Medicare is a mere 1.3 percent.

Being in private practice, Gray should know private insurance companies in general are much more difficult to deal with than Medicare. Private insurers require more pre-authorizations and deny care at a much greater rate than Medicare ever has. It’s a complete fallacy that if government “gets out of the way” then doctors, clinics, and hospitals would be able to take care of patients. If government gets completely out of the way, we’re now allowing insurance CEOs and shareholders to make all the decisions. Their only motivation is profit, which is a gross conflict of interest. Surely we can do better than that.

The only way to fix our system once and for all is to eliminate private, for-profit insurance companies. We can continue to try to make a system work that includes these middlemen, but it never will.

Myself and 400,000 other physicians support a Medicare-for-all system. Simpler for patients. Simpler for doctors. It’s time we join the rest of the world.

Dr. Sean Lehmann is chair of the Nevada Chapter of Physicians for a National Health Program, www.pnhp.org.


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