Common sense can help us develop new ways to offer health care

When I try to explain our health care system to people around here in northwest Arkansas, I do not reach for policy language. I reach for farm talk.

Imagine you call a local mechanic because your truck will not start. You trust him. He knows you, knows your truck, and tells you straight what is wrong and how he would fix it.

That should be the whole deal.

But in health care, it never is.

There is the agreement between me and the patient. That is the exam room conversation. I listen, I examine, I give my best medical advice, and we decide together what makes sense. That relationship is personal, direct, and built on trust.

Then there is a second agreement between me and the insurance company. They tell me what I am allowed to do, how I have to document it, what hoops I have to jump through, and how much they think my work is worth. The patient is not in that room, but the rules affect every decision.

Then there is a third agreement between the insurance company and the patient. Premiums, deductibles, networks, exclusions, and surprise bills that show up long after the visit. Most people do not really understand it until it hurts.

Three contracts for one visit.

It is like hiring a farmer to cut your hay, but another company decides which tractor he can use, how many passes he is allowed to make, and whether they will pay for fuel after the job is done.

When things go wrong, everyone points somewhere else.

Patients get frustrated with doctors.

Doctors get buried in rules.

Insurance companies point to the fine print.

And the simple goal of taking care of people gets lost in the middle.

I keep asking the same question. Why does it have to be this complicated?

Why can we not strip this down to something more honest and more human?

Most things that work well in rural life are simple. You know who you are dealing with. You know the price. You know who is responsible. When something breaks, you fix it, not the paperwork around it.

Developing new ways to offer health care is not about technology or buzzwords. It is about untangling a system that has drifted far away from common sense.

Good medicine is not complicated.

The system around it is.

And I do not believe it has to stay that way.

Dr. Adam McCall is the founder of Advanced Primary Care in Springdale, Arkansas. This post was originally published on Dr. McCall’s LinkedIn profile. Reprinted by permission.