When Doctors Compete – You Win

Politicians love to talk about the rising cost of healthcare. If the trend or rising prices doesn’t change, the implications for consumers and the economy could be devastating. While many government-imposed solutions are promoted every elections cycle, maybe it’s time to allow the free market to have a chance.

The 1990s ushered in Managed Care, which was supposed to control the cost of health care. Insurances networks were to keep prices down by controlling providers. Sadly, what actually happened is that health care costs have continued to rise at staggering rates while limiting consumers’ choices and diminishing the quality of care they receive.

By limiting consumers’ choice of providers, insurance companies actually discourage people from getting the care they need when they need it. Instead of going to his own chiropractor, dad just might take over-the-counter pain relievers until his problem is so bad that he misses work and requires more expensive interventions such as physical therapy, potentially dangerous prescription pain killers or even surgery. Or, instead of being able to go to the family doctor on a regular basis and prevent potential problems, families end up waiting until a full-blown crisis arrives requiring significant medical help and expense.

It’s obvious that the current system favors insurers’ short-term financial objectives over the long-term health and well-being of consumers. Experience has shown that insurers will change provider networks routinely to reduce costs while premiums continue to rise. Again, the end result is less care (quality and quantity) and higher premiums. Yet, politicians of both parties continue to promote insurance as the only solution to the health care crisis.

With little fanfare, doctors are starting to run their practices more like a business and showing a real willingness to compete for your business. This competition is taking place on several levels. Some offer affordable financial plans and fees while others specialize in a limited scope of services. Medical Homes of America based in Georgia offers unlimited care at a low annual fee, which enables their clients ready access to routine medical care. Regitz Chiropractic in Lancaster, Pennsylvania offers a “box-on-the-wall” practice where practice members determine the fee that is appropriate for them and their family Medical boutique practices have sprung up all over America offering specialized services from plastic surgery to laser eye surgery.

In short, doctors of all stripes are growing tired of the hassles of dealing with a third party reimbursement structure that limits their ability to practice and serve their clients effectively. While some providers choose to remove themselves entirely from the insurance “game”, others are choosing to opt out of networks in order to provide quality care while allowing their patients to use their insurance benefits. Either way, these providers often choose to accept somewhat lower compensation than to give less than quality care.

So, why don’t insurers participate in free market solutions to lowering health care costs? Well, one reason might be that our national addiction to insurance is fed by fear of rising costs and the potential for financial devastation should a health crisis ever occur. Many Americans take low paying jobs simply to provide health insurance for their family. Another reason might be the misconception that insurers can control costs by pressuring their network of providers. And while they may lower what they pay their network providers, they end up shortchanging the people who pay their premiums.

Given all this, how can competition alter the course of health care in America? Fewer restrictions by states on how health care providers can establish their fees would give consumers more choices in how they pay their doctor. Professional groups generally oppose this because doctors don’t like to compete for your business. Insurance companies can participate in this revolution by adopting an “any willing provider” posture. As long as a provider is licensed in a given state he/she is presumed to be competent to practice. This one change would foster a level of competition and service not seen in decades.

What can consumers do to help these changes happen sooner? Since state legislatures generally regulate how professional practice, the best first step is to contact your own representative. Tell them you want more competition in the health care marketplace. Support “any willing provider” statutes in your state. Support legislation that removes barriers to pricing by health care professionals. Tell your employer that you want access to any licensed practitioner with your health insurance policy. Finally, be responsible for your own health. Choose a policy that gives you maximum control over your own health care decisions. And, choose the provider you want before the need arises. Discuss their fees, policies and philosophy of practice.

Competition always lowers costs and improves service. Look for ways to make your doctor be better. You’ll be glad you did.