I don't claim to be the expert, but.....
Look at the Oxford Liberty plan, for example. There's a euphamism: Liberty! What liberty? There is none in the Oxford Liberty plan. In fact, it's sometimes so difficult to find a doctor that accepts it, that it seems like just the opposite. Then try getting a referral.
Oh, forgive me, yes I know. Insurance has helped a lot of people receive medical care, but unfortunately, access and good medical care are not necessarily equivalent. Would people enroll in the Oxford Liberty plan if they knew how difficult it was to get a referral? Or to find a doctor who accepts the plan? I don't know, because it's those same people that have allowed something like this to evolve.
Now we're heading towards a physician shortage. Yes, call me a doomsday naysayer or whatever you like! This is what the buzz is all about nowadays. The medical profession is becoming less and less attractive as a profession to our young, intelligent hopefuls of the future. After all, who wants to study/work hard for over 10 years, acquire thousands in school loan debts, then watch their insurance payments fall year after year while they're working themselves to the hilt trying to see more patients to make ends meet during their prime years, hoping to own a home, hoping to have a family and perhaps retire by the age of 90? That is, if they don't die of a heart attack! Yeah, well you think that doctors make too much money? You should consider all of the sacrifices they make, and the fact that by the time they emerge from their training they've already lost an entire decade of their working life.
Bitter? Nah! I'm in the game because I started out with a certain set of ideals. But I also want to be able to support my family and give my children a hopeful future. It's funny how people would never think twice of ordering a meal at a restaurant and pay for it, but they may question an insurance deductible. This feeling of entitlement, and lack of appreciation is what is leading us to a healthcare crisis by the year2020.
The solution: have people own up to their care. Instead of spending thousands on insurance plans, have plans that cost less, but cover costly tests, like CT scans and hospitalizations as well as preventive screenings. Doctors should drop insurance plans in mass. Then, perhaps they will listen. The insurers have all the power now because they've somehow convinced all the docs to enroll. If no docs wanted to enroll, or only enrolled in plans that participated in an enhanced fee schedule through an IPA so that quality care can once again be administered, then perhaps the insurance plans would start thinking twice about their greedy, profit-seeking methods.
Before there's a crisis, doctor's should make a pre-emptive strike. Drop your insurance plans one by one, starting with the most troublesome, weakest payers. If insurance plans faced the threat of losing multiple providers (then consequently insured patrons) for even as little as 3 months of repeat infractions with no corrections, they might think carefully about their methods. They have all the power now, and they're the reason that this country will face a physician shortage by the year 2020.
Maybe I'm wrong. But if I'm right, you better be damn sure I'll be referring back to this posting in 14 years. For now, I'll continue to think that I will create the ideal practice situation for myself, in spite of everyone else's actions.