fatal shooting incident United Healthcare CEO Brian Thompson The public's deep dissatisfaction with the health insurance industry is coming to the surface.
On Friday's “CBS Morning,” Dr. Celine Gounder, CBS News medical contributor and KFF Health News public health editor, said the main problem is that health care costs are too high. .
“What we're seeing in this country is that the number one cause of bankruptcy is health care expenses,” she says.
According to the report, medical costs are the biggest concern for families in this country, after groceries, transportation, and rent. KFF polling.
“We've reached a point where health care is so inaccessible and unaffordable that people are understandably frustrated,” Gounder said.
Can the insurance industry do anything about high costs?
There are things that can be done, Gounder said.
For example, under President Barack Obama, Affordable Medical Care Actcontributed to the expansion of health insurance.
“You had medicaidyou had market“Subsidies are also available to make plans more affordable in the marketplace. These have become even more generous during the pandemic, and even more generous under the Inflation Control Act under President Biden.” The subsidy has been extended,” Gounder said. ”
However, the question of why medical costs are rising still remains.
“While efforts are being made to expand coverage and make health care more accessible to more people, prices are rising,” Gounder said.
What changes might occur in U.S. healthcare?
In the United States, people are facing rising medical costs and insurance premiums.
According to KFF poll Since the beginning of this year, one-quarter of U.S. adults say they have withheld or avoided the care they needed simply because it was too expensive.
Compared to other developed countries, the U.S. has a “very piecemeal” approach, Gounder said.
“Many other countries have what is called socialized medicine,” Gounder said. “By the way, Medicare is socialized care, but even that socialized care is the most expensive in the world in terms of health care for the elderly.”
She said various suggestions were made to improve the situation. inflation control lawwith the aim of negotiating lower drug prices.
“We have already had one round of price negotiations. The next government wants to eliminate The Inflation Control Act, at least many of its provisions. So we don’t know if that will last,” she said.
The healthcare industry is also experiencing mergers and acquisitions, which means less competition.
“The Biden administration is going to move forward with antitrust litigation in earnest to stop some of these,” Gounder said. “The previous administration, the Trump administration, tried to increase transparency in health care pricing. This was another way to try to improve the situation. It's not enough. All of this points to a larger problem. We are trying to solve it little by little.”
What you can do if your claim is denied
Doctors are increasingly sharing their experiences in social media posts. claim is rejected –Gounder is also looking at something.
“What we are seeing now is insurance companies increasing their use of AI to deny claims, and health systems developing competing AI to combat health insurance AI. ” she said. “As a physician, I have to spend a lot of time on the phone with different companies trying to explain why patients are in the hospital.”
If you determine that your claim has been denied, Gounder suggests following a few steps.
- Gather all the documents you can to make your claim
- Please carefully review the statement you received and any issues.
- Find out what your doctor can do about filing an appeal
- Consider the state insurance commission that regulates insurance, which you can also sue. go to naic.com And check your condition.
