Cathleen London — a primary care physician in Maine — wants Americans to know the real reason why healthcare is still too costly for most people.
London operates a small shop out of Milbridge, Maine, a small town of just 1,500 people not far from the Canadian border. Because she’s so far away from the nearest emergency room or from a specialist, her office serves as a de facto urgent care center for the community, and she’s been trained to handle nearly every malady out of necessity. As London wrote in the Portland Press Herald, dealing with insurance companies is a nightmare, because they typically fight to cover even the smallest injury or sickness.
Anthem Blue Cross kept me on the phone for 45 minutes regarding a breast MRI recommended by radiologists on a woman whose mother and sister had died of breast cancer… Anthem did not want to approve the MRI unless it was to localize a lesion for biopsy, even though the mammogram had been inconclusive! This should have been a slam-dunk fast track to approval; instead, dealing with Anthem wasted a good part of my day.
Then Aetna told me there is no way to negotiate fees in Maine. I was somewhat flabbergasted. I do more here than I did in either Brookline, Massachusetts, or New York. The rates should be higher given the level of care I am providing. I have chosen not to participate with them. This only hurts patients; however, I cannot keep losing money on visits.
In her op-ed, London elaborates that because of private insurance companies’ decision to burden customers with a higher share of healthcare costs, London ends up paying roughly half of her employees’ health insurance due to insurers not reimbursing her for the care she provides, not because she is required to, but “because it’s the right thing to do.”
“In one day, I encountered everything wrong with insurance,” London wrote. “I am not trying to scam the system. I am literally trying to survive. I am trying to give care in an underserved area.”
However, London didn’t blame the Affordable Care Act (Obamacare) for her frustrations with the healthcare system. Rather, she placed blame directly on insurance companies, and credited Obamacare for stopping “the most egregious problems with insurance companies.”
“Remember denials for pre-existing conditions? Remember the retroactive cancellation of insurance policies? Returning to that is not an option,” she wrote.
London suggested that one avenue patients could explore is negotiating the cost of primary care directly with their physician, rather than paying an insurance company that routinely stiffs doctors to serve as a middleman.
“When both patients and physicians are frustrated, we know that only greed is winning, and the blame for that lies with corporations,” London wrote.
Kevin Wallace is a journalist with five years’ experience in print and digital media, and covers politics, media, and culture for the Resistance Report. He lives in Tallahassee, Florida.