Health care for the benefit of businesses, not patients

Personal Injury Form August 15, 2023 Aug 15 2023

Imagine you are never allowed to choose your doctor. Imagine you are never allowed to choose your health insurance company. Instead, the insurance company you did not select picks the doctors you are allowed to see. The client is someone other than the patient. Who does the doctor work for and who does the doctor serve?

This has long been the reality for any Iowa worker injured on the job. The workers’ compensation health care system exists as an alternate health care system you hope never to use. An occupational physician is akin to your general practice physician. The occupational physician is the gatekeeper. They decide whether or not there is anything wrong with you; they decide whether or not you are allowed to see a specialist. Unless you are injured at work you will never see an occupational physician; 100 percent of their work is handed to them by an insurance company who would prefer there is no injury. The people who pay an occupational physician’s bills want the treatment to be short and cheap.

Even if the occupational physician decides you should see a specialist, the insurance company can intervene. Maybe they don’t think you need to see a specialist who will provide care just yet. They may first send you to a doctor for an evaluation on whether you need care. Insurance companies like to call this an “independent medical evaluation” (IME). The irony is thick. A doctor agrees to take money from an insurance company to see a person one time and provide answers to the insurance company questions. Do they really need care? What about that preexisting condition?

If a referral to a specialist is made that does not exactly get you back into the mainstream of health care. Insurance companies learn the tendencies of specialists. Moreover, specialist physicians can have one foot in the workers’ compensation field and one foot out of it.

A good example is the Work Injury Recovery Center (WIRC) at University of Iowa Hospitals and Clinics. They advertise, “If one of your employees is injured on the job, you have multiple goals. You want them feeling better quickly and back to work as soon as they’re healthy enough to return. You also want your company’s workers’ compensation cases handled as efficiently as possible.” Read that again. The goal is not, “we will heal them.” Your University of Iowa Hospital is telling insurance companies, “we will get your injured workers back to work as quickly as possible, as cheaply as possible.”

It is not just University of Iowa Hospitals and Clinics advertising how they provide medicine in a way that puts business interest first and patients second. UnityPoint St. Luke’s WorkWell advertises, “We understand business — your business. We partner with more than 400 companies to solve their business health needs.” Mercy Occupational Health summarizes its philosophy by, “after a workplace injury, the longer an employee spends off the job, the lower their likelihood of returning to work.” No citation to authority is provided for that claim.

If you are hurt the insurance company chooses who will treat you. Hospital systems have built an alternative medical system designed to meet the needs of business, not the actual people who are supposed to receive care. And perhaps it should not surprise us that medical providers are willing to advertise that they limit their providing medicine in the name of efficiency and business needs.

There are actually four modern versions of the Hippocratic oath. One mentions remembering that a physician treats a sick human being whose illness affects the person’s family and economic stability. Another states “I shall charge only for my professional services and shall not profit financially in any other way as a result of the advice and care I render my patients.” None of them mention insurance companies.

Nate Willems practices labor law in Cedar Rapids. This was first published in the Prairie Progressive.

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