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Letting a health insurer like UHC rate doctors on cost and quality of service is a complete conflict of interest on par with letting the fox in the chicken coop. So-called health insurance insures neither our health nor our health care, but rather the company's profits, as evidenced by UHC's CEO who recently retired with a benefit package in the area of $100 million. The blatant term "medical losses" is an industry term for an insurer actually having to pay for care, care which their insurees have already paid for through their premiums. And thank you Mr. Lehrer for repreatedly skewering Tyler Mason, UHC VP, with your sharp questions. Bravo Brian, why indeed should we trust UHC?

How Can a $124.8 Million a Year CEO Make Health Care More Affordable?

Bravo Brian! Great that you're challenging the United Healthcare guy with some good questions, I wish you had done that to Miller and Krystol but this piece today is why I tune into NPR.

I used to work in a primary care practice that offered "walk-in" service for anyone who wanted to be seen the same day. The appointments were often booked weeks in advance, so a lot of patients did end up waiting hours to be seen. The patients were seen without an appointment and many of my patients said that this was far and away the most important factor in choosing a physician.

These patients are fortunate because the physicians in this practice work very hard to treat patients to the best of their ability.

Does the absolute cost that the doctor charges patients and insurance companies even matter? Insurance companies I've seen negotiate to pay a much lower price than the doctor would charge and is thus the real price of care. When I met patients who were uninsured, physicians I worked with often tried to minimize the cost of the visit as much as possible, often a much smaller amount that they would have "charged" for services.

I'd like to see a quality framework for evaluating physicians. This is a model or theory of the various aspects of quality healthcare that are important for the consumer. Measurements would derive from the model. Healthcare data systems at insurers and at providers could be modified to provide the data. It'd make measuring quality much easier.

A quality framework might include such technical aspects related to the disease and treatment, personal aspects related to the patient's experience, and cost or efficiency of treatment.

When my son was 3 and needed a tonsillectomy
the pediatrician recommended a doctor I thought
too expensive and selected a different one.

When he saw my son afterward and I said I had gone elsewhere, he said I had made a mistake.
My doctor left some scar tissue that his recommendation would not have. Who knew?

Unfortunately, many of us are given a list of PCP's from our providers. Their criteria are apparently not concerned with patient satisfaction. My PCP schedules many more patients than can possibly be seen which means if I have a problem I want to get discuss, my only hope is that it is a very slow day. A good day at the waiting room is anything under 1 hour, and that is if I am lucky enough to be the "first" patient of the day. My usual wait is 1 1/4 -1 1/2 hours, and that is just to get into an examining room. From there it is usually at least 30 mins before the Doctor shows up. By then my blood pressure is elevated, my feet are numb, and I have been in the lovely "gown" long enough to feel it beginning to fall apart.

So I will be changing my PCP, but I will be finding on based on patients' reports and time spent with each patient. The 'assembly line" approach is just wrong. And it looks as if THAT is a plus for insurance providers: more patients mean more bucks (especially since I will have to pay an additional 2-3 copays in order to get enough time to discuss problems). And of course, each appointment takes a minimum of 3-4 hours which impacts my job. Which means these appointments may string out over a few weeks, so the problem may get worse in the interim. A very vicious and unfair cycle caused by insurance "effectiveness" and profit-driven health care.

i think we all need to read a lot, with jaundiced eyes to become informed - and network so you know doctors to call when you need help. I am lucky to have many physicians in my family - I get so annoyed when I hear my friends relying on what NY Magazine says about "top doctors". When I was growing up it was considered unethical to solicit press for doctors. I think all the rating is in the end just marketing and doesn't tell the consumer much.

The state government has data on which hospitals kill and which cure. Why doesn't the government release the data they have?