This is hardly a “system” of coordinated care. Insurance companies make a lot of money, and as STAT reported in the Globe (“After shooting, a surge of anger,” Page A1, Dec. 7), consumers have lots of pent-up anger.
Almost every day, a piece of the health care system, if you can call it that, is reported to be broken. Last Sunday, in Adam Piore’s front-page story “Emergency response, in distress,” it was the EMS system. Previously, it was emergency room overcrowding as patients wait for beds. There have been articles about how hard it is to find a provider, huge gaps between follow-up appointments, high medication costs. And, of course, stories about insurance companies denying or limiting access to care and big problems over in-network and out-of-network providers.
The Globe, like most news sources, usually reports on one broken piece at a time. This creates an impression that the problems can be solved one at a time. Meanwhile, many hospitals are thriving, as are insurance companies. High salaries and bonuses to top executives hide the simple fact that many providers are grossly underpaid, often in systems where administrative costs are excessive.
Maybe it is time to try and look at the systems of care and track more closely where all the money goes. Clearly there is plenty of money spent on health care, but a high percentage of that money seems to go to administrative overhead and profits.
Maybe the system is not broken but, rather, structured carefully, as most successful businesses are, to make some people wealthy. Maybe the real problem is lost in the many pieces that are involved. Maybe too much money goes into the wrong pockets. Following the money would be a good start.
George Sigel
Boston
The writer is a community psychiatrist.
Want to fix our broken health care system? Follow the money.
