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Healthcare bankruptcy…while having health insurance

Jawad Arshad, MD, CEO, WoW Health Solutions

In my conversations with people about the healthcare coverage, most everyone is under the assumption that they need health insurance in case of an unexpected illness. Facts unfortunately do not support this misplaced trust in having insurance and being immune to financial disaster from a health emergency. 60% of all personal bankruptcies in the US are due to healthcare bills--this is terribly sad that healthcare is causing about 25 million Americans every year to succumb bankruptcy. However, even more disturbing is the fact that 75% of these individuals have health insurance...so much for thinking that having health insurance is somehow going to protect one from financial ruin in times of health emergency.

Let me be very clear, I am not suggesting that we do not need some strategy for emergency care, it is just that the current paradigm is not working. We are paying way too much in costs like premiums, deductibles and copays and receiving too little. It’s time to explore our relationship with the healthcare market and approach it as a direct consumer where the patient-doctor relationship is at the center and these parties who are directly vested in outcomes are dictating the kind and therefore cost of care.

We should appreciate that healthcare will be more attainable and effective when we interact with it as consumers. We should understand that medical care can be really parsed two large categories:

  1. Non emergency care where we have time to research, think about our priorities, and obtain the most cost effective healthcare. This is mostly true of all outpatient care. With the advancement of medicine, more and more procedures and care can be rendered in outpatient settings where the cost of doing procedures is usually about one fifth of doing the same procedure in a hospital setting.
  2. Emergency care where there isn’t enough time to decide which tests are needed. We can not expect patients to make decisions in these times, and so we must demand that healthcare institutions provide us with “bundled” pricing. If every patient who gets admitted is charged a flat rate per day in the hospital, it creates an incentive to for the hospital to be efficient in its operations. Patient feedback in public forums for other patients to see, and outcomes parameters enforced by regulatory agencies will help create a system of checks so the hospital is not cutting corners in providing good quality care.

These strategies will help bring transparency to the healthcare market.

About Author

Dr. Arshad is a practicing physician with extensive administrative experience, who has firsthand knowledge of running a medical practice and working in employed models. WoW Health aligns incentives for the healthcare ecosystem so all stakeholders benefit from transparent and direct relationship between patients and medical service providers.

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