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Putting people first in health care

By Adina Marx,


A person goes to the doctor. She’s been having back pain for a few weeks, but put off seeking care because she has a high deductible and needs her next paycheck to help cover out-of-pocket costs. The doctor she sees suspects it’s a muscle issue, but recommending physical therapy wouldn’t generate much profit for the large hospital corporation he works for.  Instead, the doctor orders a battery of tests X-rays, and MRIs.

How did we get here? What is preventing doctors from giving patients the high-quality care they deserve, and doctors and nurses want to provide? Why isn’t the optimal health and well-being of people the focus of health care in America?

Thanks to the power that corporate CEOs and their lobbyists have, health care providers are incentivized to put billing and profits first, not the ability of people to get and stay healthy. Over the next year, Families USA will roll out our vision for how we can unrig this system and what health care in America could be. We’re calling it People First Care because people’s health should come first, and doctors should be rewarded for providing high quality care, not ordering harmful, useless and costly tests and procedures. Stay tuned as we share our vision here in the coming months.

It’s not as though big health care corporations lack funding. On the contrary, nearly a quarter of people in America with insurance through their employers are paying too much in premiums, too much out of pocket, or both. Costs that high make it harder for families to pay for necessities they need to live, like food and housing. Despite all the money pouring in, the quality of our health care – and our health – isn’t improving. We have extremely high rates of several chronic illnesses, including diabetes, arthritis and heart disease. We’re dealing with a gun violence epidemic with no end in sight. We’re clearly not taking care of our mental health either, with our high suicide rate serving as just one example.

Put simply, we’re spending astronomical amounts without getting results. The numbers clearly show this. Seventy-five percent of Americans believe we are not getting our money’s worth in health care and they’re right.

So where is all our hard-earned money going? Mostly toward perpetuating a system that pressures providers to say someone has been treated, not that they are healthy. Complicated administrative systems and failure of providers to coordinate with each other contribute to the soaring costs of health care in this country. Imagine if things were reversed – how beloved these companies would be and how their stock prices would soar.

Like nearly everything else with health care, these issues hit people harder when historical and current policies too often mean their concerns go unheard, like they have against Black, Indigenous and other people of color. If a person faces bigotry, they may face housing discrimination, forcing them into unsafe homes or job discrimination, preventing them from making enough to afford nutritious food and necessary medications. This has an impact on your health, but it’s too often seen as a separate problem. With People First Care, doctors would be encouraged to coordinate care and help figure out long-term solutions to help people get and stay healthy.

Taking the example of someone going to the doctor for back pain, we can see exactly how doctors aren’t being rewarded for providing the best care. Payment for physical therapy isn’t nearly as much as tests and other procedures, and right now our systems are set up to pay doctors for how many procedures they do, not how healthy a patient becomes. This can be outright dangerous for patients if those procedures and test are risky to their health long term. Large health corporations are using our health like a sales competition, forcing doctors to order as many procedures as they can charge for and make the most ‘sales.’

We all know that health care in America is failing people and their loved ones. Large health care corporations are failing to provide affordable, quality care to keep everyone in our nation healthy.  Instead, every gear in the health care system is grinding to write the most prescriptions, order the most tests and see the most patients. This needs to stop.

Families in America deserve to be able to go to their doctor and know their health is the only thing on the doctor’s mind and our doctors should be rewarded for looking at root causes of health problems. Changing the way doctors are incentivized would make our health care system work for everyone. We all deserve better, and Families USA’s People First Care will make the case for exactly how we get there. Check out our first paper here, and follow along on our Twitter to hear about the latest updates to People First Care.