Aetna Insurance denies treatment to breast cancer patient

[KentuckyWoman]

42. Putting some brakes on fee for service medical care

Even when you have a non profit, you find doctors sending someone for advanced imaging instead of simple xrays because the diagnostic is billable at a higher rate in a fee for service system.

I currently am on straight Medicare, and all my doctors are connected University of Cincinnati. It is as close to non profit as I can get. And yet I regularly have to put the brakes on my own doctors. For instance, I take aspirin and generic plavix. They wanted me on warfarin 20 years ago and I said no. Now it's Eliquis. I said no.

There are too many people who feel entitled to every expensive pull out all the stops medical care. Too many doctors will do it because ever service can be billed regardless of whether the cost/benefit is really there. On the other end patients show up in the doctors office wanting some cutting edge something to make it go away and go doctor shopping if they are told there is no way to make it go away.

These issues exist even in a non-profit world. Add the pressures of a for profit system to it and it is a recipe for even more trouble. If we want to fix the broken system we have to address fee for service in addition to the profit system in medical care.