# Reevaluating the Function of Insurance Companies in Healthcare
## A Plea for Increased Responsibility
Picture yourself in a courtroom where the defendant isn’t a person, but a formidable insurance corporation. The accusation? Refusing coverage for a critical treatment, resulting in dire repercussions for an individual’s health. The prosecutor faces the jury and proclaims, **”They favored profits over human lives.”** It may sound extreme—but is it truly that out of reach from reality?
What if insurance companies were **held responsible** for the fallout of their decisions? We expect physicians to be accountable for their choices—why shouldn’t the organizations that determine our healthcare access meet the same expectations?
## What If Doctors Made the Calls?
Currently, numerous insurance claim decisions are made not by **medical professionals** but by administrators fixated on cost savings. What if these insurance companies were led by **seasoned physicians** instead?
Doctors are already tasked with making **critical decisions** in hospitals and clinics. They grasp the urgency behind sanctioning a necessary procedure. If insurance rulings were managed by **clinicians—not bureaucrats**—we might eliminate ridiculous obstacles, such as having to provide 15 years of medical documentation to support a standard procedure.
In such a framework, approvals would rely on **medical urgency** rather than **financial calculations**, ensuring that individuals receive the required care promptly.
## Promoting a Healthier Community
Now, let’s explore this further. What if **insurance plans actively incentivized preventive services**?
– Regular screenings, such as **mammograms or cholesterol screenings**, could result in reduced premiums.
– Achieving health milestones—like **quitting smoking or engaging in consistent exercise**—could help lower deductibles.
– Focusing on **mental health check-ups** could also be rewarded.
Preventive care benefits not just individuals, but also contributes positively at a **national** scale. Chronic illnesses like diabetes, heart disease, and cancer account for **90% of healthcare spending**. By enhancing early detection and prevention, we could drastically cut medical costs and promote overall health.
Imagine getting an annual insurance report that stated, **”Congratulations! Your healthy lifestyle choices helped save the system $12,430 this year!”** Wouldn’t that be inspiring?
## Why Is Health Insurance Linked to Employment?
In the United States, around **60% of individuals** obtain insurance through their workplaces. Lose your job? Lose your health coverage. This security should not rely on your employment.
Countries like **Canada and the U.K.** have universal healthcare systems that dissociate **employment from healthcare access**. While no system is perfect, their citizens typically don’t fear **financial ruin due to medical expenses**—a terrifying situation for many Americans.
Healthcare should be a **human right**, not a benefit tethered to employment dictated by corporate policies.
## The Flawed Foundations of the U.S. Healthcare System
The current employer-based insurance structure **wasn’t designed—it developed**. During World War II, wage caps prompted companies to provide health benefits as an incentive for hiring employees. Over the years, this transformed into the **standard practice**, eventually evolving into today’s bureaucratic mess.
The Affordable Care Act (ACA) sought to create a more equitable system, but it still falls short of an **ideal framework**. Reflect on this statistic:
👉 In 2023, **U.S. insurance firms earned $88 billion in profit**, while **medical debt remained the leading cause of personal bankruptcy.**
That illustrates a dysfunctional system.
## A Nation’s Health Reflects Its True Wealth
As a healthcare professional, I observe the **personal toll of our inadequate system**. Individuals postpone essential care due to insurance bureaucracy, only to face serious consequences later on.
An authentically **effective healthcare system** wouldn’t **burden patients with paperwork but uplift them**. It would place **well-being ahead of corporate profits.**
## The Imperative for Reform
If you’re discontented with the **existing system**, that’s a good sign. Change arises when individuals **speak out and advocate for reforms.**
💬 **Discuss it.** Share experiences of insurance rejections and healthcare challenges.
📣 **Promote policy reforms.** Support lawmakers who are fighting for fairer healthcare systems.
🩺 **Heed the insights of physicians.** They know the medical truths behind these choices.
As the late **John Lewis** famously stated,
> “Never, ever be afraid to make some noise and get in good trouble, necessary trouble.”
It’s time we demanded a **healthcare framework centered on patients—not profits.**