to Our Healthcare Reality
Most Americans know our healthcare system is broken. Yet surveys show we continue to regard doctors more highly than virtually any other profession.
In fact, the latest Gallup Poll data show that Americans’ trust their doctors’ honesty and high ethical standards. Their “approval ratings” on this count increased from a low of 47% in 1994 to 70% in late 2012 – behind only pharmacists (75%) and nurses (85%).
Yet healthcare spending – driven largely by doctors – remained essentially flat for the rest of the 90’s. Healthcare spending has almost doubled since the year 2000, however, while doctors’ approval ratings have climbed. And, according to the highly respected Kaiser Family Foundation, employees’ contributions to their health insurance premiums have increased by 2 1/2 times since 2000.
How to explain this apparent disconnect between out-of-control medical spending that’s largely due to medical mismanagement of various kinds and the continuing high public regard in which our doctors are held?
The simplest explanation is that the blame for our broken healthcare system is largely attributed to pharmaceutical and health insurance companies, which bear the brunt of the burden in public opinion polls.
This is a comfortable “escape” for us because exonerating our doctors from culpability, even subconsciously, permits us to feel safe in their care. Who wants to be sick, after all, and have to worry about whether our doctors really have our best interests at heart? It’s just too much to comprehend, especially in such a compromised state.
It’s easier to just blame it on “Big Pharma” and be done with it.
If only it were that simple…
Pervasive Conflicts of Interest
The esteemed Gary Schwitzer did a quick wrap-up at MedPage Today of recent conflict of interest reports in the media. Seeing them all bundled together like this helps us appreciate just how pervasive these are in a healthcare system in which millions of Americans continue to place their trust.
And the conflicts aren’t limited to academic research bankrolled by “Big Pharma” or the other usual suspects. They extend instead to the very practice of medicine itself. Indeed, they’re enabled and even encouraged by a fee-for-service payment scheme that rewards doctors and hospitals for doing more to patients instead of more for them.
This table from Our Healthcare Sucks summarizes the financial conflicts-of-interest between patients and their doctors inherent in America’s fee-for-service payment system – a payment scheme that will remain dominant for many years to come.