by Dr. David Robinson

Created on: April 02, 2008   Last Updated: April 28, 2008

We are in a mess today because of some misconceptions and some facts that have deliberately been ignored. Not any more!

Let's first put to rest a misnomer, "Health insurance". It is not your "health" that gets "insured". The reality is that you are paying a company a set dollar amount, a premium, to pay for an agreed upon percentage of certain health care expenses in the event that you need health care services.

This is more like a hedge fund than an insurance policy! A hedge fund for the health care insurance company, because they are betting that people will pay an ever increasing premium each year and not have any health care expenses. And a hedge fund that gets better every year for the insurance company, because as they increase their policy premiums, co-payments and deductibles, they very stealthily reduce and eliminate the health care services they'll pay for.

It is not ironic that health care insurance corporations' profits and the annual incomes of their brokers who sell their policies continue to increase dramatically, every year!

But there are some other facts surrounding the big picture of health care and health care insurance that need to have center stage, other than just health care providers' costs and fees.

Over-utilization is an issue with many causes. Among them are: "Defensive" medicine by doctors trying to avoid lawsuits; patients' demands; a belief among doctors and patients that newer (but more expensive) technology is better.

But the most ignored and least admitted factor may be the financial necessity born out of our current third-party payment system. Medical doctors were, in the past, reimbursed fairly and at a good percentage for whatever they billed. But as reimbursement rates have declined in recent years, most doctors have been forced to adapt by increasing the quantity of services. With the health care insurance companies decreasing the amount of doctors' reimbursements (income) per service, the only way to maintain practice with its continually increasing overhead, is to increase the amount of services provided.

This unfortunately leads to the harsh fact that trying to practice ethical medicine doesn't help a doctor's bottom line and can well lead to financial problems for him/her.
As a result, today doctors are forced into doing too much testing and too many procedures, often for the sake of simply making a living.

In addition to "over-utilization" and the high costs of medical services, the problem also includes the high costs of a

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