As healthcare providers, we took an oath to prioritize the health and well-being of our patients above all else. Unfortunately, the modern healthcare landscape often forces us to confront a disheartening paradox. While healthcare insurance companies continuously implement cost-saving measures to bolster their profits, these policies can inflict significant harm on our patients, undermining the core tenets of healthcare.
To be clear, the concept of cost-saving measures in healthcare isn’t inherently flawed. Efficiency and responsible resource allocation are important. However, when insurance-driven cost-saving measures put profits before patients, the results are undeniable and detrimental.
One great example is the practice of non-medical switching, where insurance companies mandate patients to switch from prescribed medications to cheaper alternatives. While this may save insurers money, it can wreak havoc on patients’ lives. Chronic illness management often requires a delicate balance of medication, tailored to the individual patient’s needs and responses. Disrupting this balance can lead to worsening health conditions, increased suffering, and even the development of new, avoidable medical issues. One current example is patients who deal with asthma, severe atopic dermatitis and prurigo nodularis are facing that predicament since SelectHealth dropped Dupixent from coverage earlier this summer.
Another well-known hindrance for patients in the chronic care community is what is known as step therapy. Step therapy requires patients to try and fail on less expensive treatments before gaining access to the medications their healthcare providers initially recommended. While cost-effective in theory, this approach ignores the unique nature of each patient’s condition. Delaying effective treatment can lead to complications, unnecessary pain, and, in some cases, irreversible harm.
And finally, an issue that we had hoped the legislature could mitigate last session: copay accumulators. Copay accumulators prevent patients from using copay assistance from charities or drug manufacturers toward their deductibles or out-of-pocket maximums, effectively increasing the amount patients pay for their medications.
It is essential to understand that while these cost-saving measures improve insurers’ financial bottom lines, they often come at the expense of patients’ health, well-being, and trust in the healthcare system. Healthcare professionals are left grappling with the ethical dilemma of advocating for what’s best for our patients versus navigating the labyrinth of insurance policies that too often prioritize profits over people.
In a society that values human life and health as a fundamental right, we must challenge insurance-driven healthcare cost-saving measures that compromise patient care. The first step towards a more ethical and patient-centered healthcare system is to shift the focus away from short-term financial gains and toward the long-term health and well-being of individuals.
To accomplish this, the Utah legislature should engage with healthcare providers, patients, and insurance companies to develop strategies that genuinely improve healthcare efficiency without sacrificing quality and patient access. Collaborative efforts can lead to solutions that strike a balance between fiscal responsibility and ethical patient care.
It’s time we reevaluate the true costs of insurance-driven healthcare savings. As healthcare providers, our commitment remains unwavering—to advocate for the best interests of our patients. It is our hope that our State will join us in this mission, prioritizing patients’ health and well-being above all else. After all, the true measure of a healthcare system’s success is not in its profit margins but in the health, happiness, and dignity it preserves and promotes for every individual it serves.
Maryann Martindale, CEO, Utah Academy of Family PhysiciansÂ
