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You may find my manifesto on healthcare in America hostile
and I don’t give a damn or crap for I am telling the truth.
Healthcare in America is a multi-billion dollar industry for
profit because it does not matter if the company is a non-
profit organization or for a profit company for United States
of America is the most capitalist country in the world, get it?

My fellow Americans, we are wired to think or see that
having a capitalist economy is essential for democracy.
Or most likely, what you call the American Dream, dream
of material success and better life, like owning successful,
profitable businesses or having highly professional roles
with high salaries, focusing on the profit for the company.
 
Healthcare is consists of hospitals, insurance companies
or organizations, other healthcare providers, like physicians,
specialists, treatment centers, pharmacies that provide
medical services, such as treatment, care, prescriptions,
medical equipment for health issues, physical and mental.
Therefore, healthcare is crucial to our overall well-being.

However, the US healthcare is focused on profit, profit
that compromises quality of care or impacts treatments.
Commercial health insurance is sold and administered
by insurance companies or carriers for profit and the
health coverage could either be PPO, Preferred Provider
Organizations or HMO, Health Maintenance Organizations.

Commercial health insurance is usually group coverage,
offered by the employer to their employees, but in some
cases an employer may give employees medical allowances
for healthcare coverage by direct purchase of individual
policies, just like how the rest of us, buying or obtaining
the coverage through agents of the insurance companies.

The insurers provide the insureds or consumers a health
policy or a health plan laying out what are covered and
what are not covered and the services are either approved
or denied according to the provisions of the policy or plan.
The limitations and exclusions are provisions that could cut
the cost down of services compromising care and treatment.

The insurers employ analysts to evaluate and resolve the
claims, either by approval or denial based on the guidelines
and provisions of the policy, like denying experimental
treatments or prescriptions, as an exclusion of the policy
They are excluded and not covered because they are
not approved by the US Food and Drug Administration.

However, these so called experimental procedures or
prescriptions are widely administered in other countries.
The insurers employ group of medical professionals to
review medical records in denying treatments based on
being found “not medically necessary” and explaining
why and suggesting alternative less expensive treatments.

The insurers have weekly meetings discussing the bottom
line, the targeted projected revenue to attain net income
or net profit for the quarter. Sometimes, weekly meetings
can turn to daily meetings, if the projected revenue is off.
The officers and upper management with high salaries are
rewarded with quarterly bonuses and other company perks.

Hospitals, medical groups and other medical institutions
operate in the same way, to meet the targeted revenue
or net profit and take care of their employees, not the
consumers or patients, but there are some physicians
who care about their patients, the physicians who work
beyond their schedules, who put in overtime without pay.

Keep in mind that one of the cost cutting techniques of
these institutions is to allot the physicians limited time
to treat each patient and do the necessary paper work.
Another one is to limit the patient’s hospital stay and
transfer them to rehabilitation centers or discharge them
early to minimize expenses to ensure the targeted profit.
   
The insurance industry is regulated by many entities:
federal, state, organizations; whereby each entity is not
aware of what the other entities are doing, creating major
inefficiencies and frustrations in the healthcare system.
Whatever, the US government is doing is very minimal
for the people of America, which is ridiculous and sad.

That is why surgeries and some procedures are more
or less expensive in some hospitals and medical groups
because they could charge whatever they want for the
government is not regulating the pricing issue, as well as
not policing Medicare and Medicaid health programs
to combat persistent fraud and abuse of some providers.
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