Medicine’s Top Earners Are Not the M.D.s

jay_tarnow Jay D. Tarnow, MD

In 1988, I predicted that Managed Care would become the biggest boondoggle in the “industrialization” of Medicine. I blamed the Clintons for handing over the driver’s wheel to the Insurance industry to monitor the healthcare system. What a mistake that was! The people who know the most about health and disease¾the doctors¾ended up with the least amount of power. What we needed were doctors to be involved in the process from the beginning. But, the Clintons did not trust healthcare providers. So, they were literally locked out of the room, as if they were the problem and not the solution. They are trained to heal, not to do business, and this cost the profession dearly. Instead, the Insurance and Managed Care companies were entrusted to bringing about new business practices in the name of saving money. However, this approach backfired as business practices lined the pockets of everyone but the physicians, while the quality and amount of care suffered.

Now, in 2014, we are saddled with a huge bureaucracy of healthcare managers, who are maximizing profits by cutting patient services. Our healthcare delivery is so over-managed that the medications approved to prescribe are constantly changing without the doctors’ awareness. Drugs approved for reimbursement are not the best available, but rather the cheapest ones. Many patients are priced out of a particular treatment and left to try multiple medications that are ineffective for them. This is often due to the insurance company not having negotiated a “special deal” with the pharmaceutical entity, causing the correct medications to be ridiculously expensive. To receive the care they deserve, the patient must pay 50 times more money for an effective drug because of “good business practices” put in place to benefit the insurance company, not the patient.

Link to the article in the New York Times here.

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