Insurance companies don’t pay doctors who get patients healthy

Doctors who can reverse degenerative diseases without the use of expensive drugs or surgeries should be exactly what insurance companies support.

Yet the opposite is true.

Why?

Unfortunately, it’s simply a matter of finance.

Americans are seeking out Functional Medicine

People like the option of getting to the root cause of their condition. They’re excited about the prospect of getting off medication and truly regaining their health, which is what Functional Medicine provides.

Insurance companies aren’t stupid. In fact, I think we should credit them for having some extremely intelligent minds within their ranks. The minds are being used in an evil direction, but it doesn’t make them any less brilliant.

They see the writing on the wall and they feel a little threatened. Despite their hundreds of billions of dollars of revenue each year and profit in the tens of billions, they see a direction in healthcare and they don’t like it.1

What do they do to work against Functional Medicine?

They attempt to make it untenable for Functional Medicine doctors to get paid within the insurance model, hoping that will dissuade Americans from trying it.

In 2018 the major carriers including Cigna, Blue Cross and United healthcare have cut what they allow per visit by 50 – 66% for out of network practitioners. This is across the board for medical, nutritional, chiropractic and physical therapy care.

Why does insurance dislike doctors who get their patient’s healthy?

Are you thinking this makes no sense? I agree. In fact, I got so fed up with the actions of insurance companies working against doctors who are truly reversing disease that I researched it in depth over the past few months.

Here is a small fraction of what I learned:

1. A study on stent operations was performed in the prestigious New England Journal of Medicine in 2007. They discovered that generic drugs performed as well as the expensive stent operation in a large number of patients.

It was deemed that a percentage of patients didn’t need to get the operation; the incidence of heart attacks and deaths was not improved for a subset of patients suffering from chest pain.

The researchers estimated that following the guidelines of their research would save our country $5 billion per year.2

Did we save our country $5 billion?

No, because your doctor and your insurance company didn’t follow the study guidelines. The number of stent operations performed in the U.S. is as high as it’s ever been. A stent operation costs about $40,000 and we perform 1 million per year here in the U.S.

Why? You know the answer – money

As one author more eloquently put it: studies that find “an already popular and lucrative treatment [such as stents] unnecessary, but not harmful, have rarely altered medical practice.”3

Does insurance embrace a lower-priced, more effective drug?

2. A generic blood pressure pill was discovered, in 2002, to work better than a costlier name-brand drug, Norvasc.

Did drug sales of the expensive Norvasc decline with this discovery? No. Sales continued to climb from $3.8 billion in 2002 to $4.9 billion in 2006. 4

3. Business operations within insurance companies changed with Obamacare. Health insurance is now required to pay 80-85% of premium monies collected on patient care. Pre-Obamacare this percentage was 70%. The difference of 10 to 15% may not sound like a lot until you do the math. Insurance companies earn about 200 billion dollars per year. Fifteen percent of that is 30 billion dollars. Spending an extra 30 billion dollars per year may sound like a “fun” problem, but not if you’re an insurance company with shareholders to report to. When Obamacare became law, insurance companies had to find ways to spend tens of billions of dollars more towards healthcare while remaining profitable.

And they did it. Again, we have to give them kudos for ingenuity. They are abiding by Obamacare, it is the law after all, and they are continuing to be more profitable each year.

How are insurance companies remaining profitable?

• Raising deductibles
• lowering the percentage of care they cover for you,
• restricting the number of visits covered,
• pushing expensive drugs for which they receive rebates 
• pushing for medical procedures [Ref: Hidden influence].

Is it starting to make sense why insurance companies dislike doctors who truly get their patients well inexpensively?

If you think about it, the resolution of degenerative disease is not something a patient has to do repetitively; patients who successfully complete a 4-month program with us are set up for a lifetime of good health if they continue the successful actions of diet and lifestyle we have laid out for them.

Insurance companies are big business

To say insurance companies are big business is an understatement; they average hundreds of billions of dollars in revenue each year.1

You’d think they’d be happy to work with ideally healthy individuals. They can collect money for deductibles every year, while not having to pay any money out for expensive drugs or surgery.

Such healthy people do not make insurance companies happy.

Health insurance companies dislike healthy people

Why? On the face of it that makes no sense.

But the truth is your insurance company makes more profit when you’re sick. Therefore, they will rail against any type of healthcare designed to restore your health long-term.

Here is how your health insurance company makes money:

1. They receive rebates on the drugs you take, even while you’re meeting your deductible. In other words, you’re paying 100% out of your pocket and they’re getting paid while you do so. Can you see why they want you to take drugs? It’s a source of income for them.
2. Your annual deductible continues to balloon upward, but “the hurt” you feel in your wallet is a profitable situation for your insurance company. They don’t have to pay for your care while you meet your deductible, so the larger it is the better it is for them financially.
3. They encourage expensive, invasive surgeries and procedures despite less expensive, safer options being available.2
4. Insurance companies continue to pay for expensive, invasive procedures, even when a placebo has been proven to work as well.
5. They “push” expensive, less effective drugs, despite evidence that inexpensive generic works better.

The proof to support these statements can be found in this Blog.

The truth about our healthcare system is corrupt and insane

From my research, it all finally clicked. It was disgustingly corrupt, but I finally understood why they were working against the health of their clients and against Root Cause Medicine and Functional Medicine doctors.

What does this mean for you?

You need to adjust your thinking: Health insurance is predominantly for crisis care. They are there to ensure you don’t need to go bankrupt in order to afford an emergency medical situation.

Utilizing the services your insurance company pays for is not going to make you healthy.

You’re going to have to do that on your own.

When it comes to the degenerative diseases killing most Americans, your health insurance company is not going to steer you in the right direction. In fact, they are banking on your ill health to continue to feed their profit.

What can you do to escape this insane healthcare system?

Ask yourself:

Do you want to reverse the chronic disease or manage it?

Drugs will manage your symptoms while the underlying cause worsens.

Root Cause Medicine can reverse it.

Which one would you like?

Your health insurance doesn’t want you to reverse your disease and they won’t pay for Root Cause Medicine.

Do you want to get truly healthy? Find a practitioner who honestly can get the job done whom you trust.

If you want the best care, be ready to pay for it

You need to “get past” the notion that if your insurance company doesn’t pay for something that means you shouldn’t do it. Remember their purpose is to make their stockholders and board members happy with the profit. Their purpose is NOT to get you healthy.

We have seen the facts that prove effective healthcare reverses chronic disease yet is absolutely frowned upon by insurance.

Unfortunately, this means you’re going to have to bypass them and pay for it yourself. Would you agree that nothing is more important than your health?

Let’s get started

We’ll begin by addressing the reason your body is giving you symptoms. We won’t suppress your symptoms with dangerous and expensive drugs, but rather fix the problem at its root.

Root Cause Medical Clinic specializes in, and achieves, the reversal of many chronic health conditions: from fatigue to digestive issues, from heart disease to type 2 diabetes, and from pain to overweight – We know how to get the job done. 

We don’t just hand you a pill. You are an active participant in regaining your health, and we are there beside you, working together as a team. You can’t do it alone, no one can.

You’re ready to regain your health; we’re ready to get you there

There’s no magic wand. You will need to change your diet and lifestyle. But the result is reclaimed health without drugs.

That’s exciting and it can all happen in just a few short months.