We are receiving brochures from a number of Health Insurance companies highlighting the fact that there are no co-payments on a number of procedures; certain types of office calls or certain types of drugs. This is very unfortunate. If any one understands over-utilization, it should be the insurance companies.

It’s a well-known fact that when anything is free, there is over-utilization. In our experience it is well over 50%. The insurance companies are again expecting doctors to be the gatekeepers, the cops, to parcel out only needed care. It is also a well-known fact that patients are referred to as members now. This makes them feel they are part of a warm and cozy family. It the doctor doesn’t give them every test, procedure or drug they want, they will complain to their insurance carrier which is now an HMO, a mechanism to control costs.

The HMO must now straddle the fence. They will not admit to their “members” that their whole purpose to exist is to control costs by controlling patient’s laboratory, pharmacy, and x-ray appetites which they expect us physicians to control. They will restrict and blame physicians as the disorganized group they control without much concern for retaliation.  (Didn’t Alexus de Tocqueville allude to this in the 19^th century?)

Physicians need to wake up to the fact that they are pawns in an encroachment on their integrity. If you cannot trust your doctor, whom do you think you CAN TRUST?

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Medical Gluttony thrives in Government and Health Insurance Programs.

It Disappears with Appropriate Deductibles and Co-payments on Every Service.