Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The problem with too many health insurance options

Tenessa MacKenzie, MD
Policy
April 2, 2017
231 Shares
Share
Tweet
Share

Medical school didn’t teach me about the intricacies of health insurance. My family medicine residency program took pride in caring for all patients regardless of insurance status. When I worked in New Zealand and Canada it was a relief to not worry about which diabetic test strips were on formulary or whether a patient’s insurance would cover their birth control.

In my current position as a primary care physician at an urban academic health center and as the debate around the Affordable Care Act continues, I feel it is crucial to make a concerted effort toward simplifying our complicated health insurance system.

As a family physician, I treasure my relationships with patients, and I’m proud when patients recommend me to their friends and families. I appreciate that the health care system within which I work accepts most insurance plans, but when my patients change jobs, lose their jobs, move, become eligible for Medicare, or their insurance plan switches networks, they are forced to get new doctors and establish care within a new system.

Many critics of universal health care argue that it limits patient choice, however, in my experience, there are overlooked negative consequences of having too many health insurance options.

This past year, my patient with a previous miscarriage was elated to be pregnant again. I saw her monthly for routine prenatal visits up until December when she was five months along. During our last visit, she mentioned her employer-based insurance was changing networks in the new year. I haven’t seen her since.

Another patient, a mother with an autoimmune illness that causes debilitating back pain, sees me regularly for most medical concerns. She also sees a rheumatologist with whom she’s built trust as they’ve discussed treatment options with significant side effects. She lives near my office, so the location is convenient. However, her family recently decided to move ten miles south, which puts them in a new county. She’d be happy to drive the extra few minutes and keep her same doctors, but because her insurance is through the county system, she is forced to re-establish care elsewhere.

Insurance changes can carry considerable costs as well as impacting continuity of care. I have an elderly patient who spent decades receiving medical care within a large managed care network. Over the years he had imaging studies and surgeries, tried various combinations of medications to control his blood pressure, was referred to specialists, and visited his primary care physician quarterly. A few years ago he transferred care. He arrived at my office with a vague history of his chronic medical conditions and some pill bottles. The clerical staff dutifully obtained prior medical records and presented me with a 300-page fax that took hours to sift through and sort out what was pertinent. I had to refer him to new specialists within our network and repeat many of the previous studies. The time and money spent obtaining and reviewing old records and repeating consults and tests are just some of the overlooked costs of a seemingly simple change in health care coverage.

It is evident that our current health insurance system is too complicated. Cryptic booklets comparing and contrasting insurance plans with varying coverage limits and deductibles are confusing for health care providers and patients alike and result in fragmented medical care and increased costs. Treating health care as a commodity and putting the burden on a sick and overwhelmed patient to shop around for medical insurance just doesn’t make sense.

I am concerned that any version of Trumpcare will add to the health insurance kerfuffle and obstruct access to care under the guise of creating more patient choice. I urge us all as health care consumers to consider the impacts of an overabundance of health insurance options and advocate for simplifying our system.

Tenessa MacKenzie is a family physician.

Image credit: Shutterstock.com

Prev

Defending the change in resident duty hour restrictions

April 2, 2017 Kevin 5
…
Next

The little-known ACGME guideline change every resident should know

April 2, 2017 Kevin 0
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Defending the change in resident duty hour restrictions
Next Post >
The little-known ACGME guideline change every resident should know

More by Tenessa MacKenzie, MD

  • California’s End of Life Option Act will provoke meaningful conversations

    Tenessa MacKenzie, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Here’s why health insurance is different from other insurance

    Joseph Crisp
  • Think you have health insurance? Think again.

    Asser Shahin, MD
  • Insurance and the destruction of our health care system

    Peggy A. Rothbaum, PhD
  • Why is health insurance so unaffordable?

    Emily O'Rourke, MD
  • If health care is a right, so should having legal insurance

    Thomas D. Guastavino, MD

More in Policy

  • Healing the damaged nurse-physician dynamic

    Angel J. Mena, MD and Ali Morin, MSN, RN
  • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

    Mohammed Umer Waris, MD
  • Breaking down the barriers to effective bar-code medication administration

    Amy Dang Craft
  • The locums industry has a beef problem

    Aaron Morgenstein, MD
  • Canada’s health workers are sounding the alarm. We must act, now.

    Ivy Lynn Bourgeault, PhD
  • Race categorizations are worsening health inequities for the South West Asian North African (SWANA) communities

    Guleer Shahab, MPH
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
    • Fostering the next (diverse) generation of clinicians

      Imamu Tomlinson, MD, MBA | Physician
    • Healing through love and spirituality

      John T. James, PhD | Conditions
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Rescuing primary care: the role of health administrators [PODCAST]

      The Podcast by KevinMD | Podcast
    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
    • From penicillin to digital health: the impact of social media on medicine

      Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson | Social media
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • How to overcome telemedicine’s biggest obstacles

      Harvey Castro, MD, MBA | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Investigational ALS Drug May Have Clinical Benefit, FDA Staff Says
  • Cases of Deadly Fungus Tripled in Past Few Years, CDC Says
  • Small Gains in Cardiorespiratory Fitness Track With Improved Longevity
  • Improved OS With Hyperfractionated RT in Recurrent Nasopharyngeal Carcinoma
  • GPT-4 Is Here. How Can Doctors Use Generative AI Now?

Meeting Coverage

  • Rapid Improvement in Atopic Dermatitis With Topical PDE4 Inhibitor
  • New Approaches in the Bladder-Sparing Paradigm
  • Response Rates in Hidradenitis Suppurativa Continue to Climb With New Therapies
  • Another Win for a JAK Inhibitor in Alopecia Areata
  • Biologic Switch Revs Up Response in Plaque Psoriasis
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
    • Fostering the next (diverse) generation of clinicians

      Imamu Tomlinson, MD, MBA | Physician
    • Healing through love and spirituality

      John T. James, PhD | Conditions
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • Rescuing primary care: the role of health administrators [PODCAST]

      The Podcast by KevinMD | Podcast
    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
    • From penicillin to digital health: the impact of social media on medicine

      Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson | Social media
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • How to overcome telemedicine’s biggest obstacles

      Harvey Castro, MD, MBA | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The problem with too many health insurance options
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...