What Doctors Like Myself Know About Americans’ Health Care Anger

Opinion|What Doctors Like Myself Know About Americans’ Health Care Anger

I rushed around the patient as he lay motionless with his eyes closed in the emergency room. He was pale and sweaty, his T-shirt stained with vomit. You didn’t have to be a health-care worker to know that he was in a dire state. The beeps on the monitor told me his heart rate was dangerously slow. I told the man that he was going to be admitted to the hospital overnight.

After a pause, he beckoned me closer. His forehead furrowed with concern. I thought he would ask if he was going to be OK or if he needed surgery — questions I’m comfortable fielding. But instead he asked, “Will my insurance cover my stay?”

This is a question I can’t answer with certainty. Patients often believe that since I’m part of the health-care system, I would know. But I don’t, not as a doctor — and not even when I’m a patient myself. In the United States, health insurance is so extraordinarily complicated, with different insurers offering different plans, covering certain things and denying others (sometimes in spite of what they say initially they cover). I could never guarantee anything.

I didn’t say all this to the man, though, because I needed him to stay in the hospital and accept inpatient treatment. So instead I hedged. “You’re very sick,” I told him. “You shouldn’t worry about your insurance right now.” I should have been able to give him a better answer, under a better system.

The killing of Brian Thompson, the chief executive of UnitedHealthcare, the country’s largest health insurer, has reignited people’s contempt for their health plans. It’s unknown if Mr. Thompson’s tragic death was related to health care, and the gleeful responses have been horrifying. But that reaction, even in its objectionable vitriol, matters for how it lays bare Americans’ deep-seated anger toward health care. Around the country, anecdotes were unleashed with furor.

Among these grievances is the great unknown of whether a treatment recommended by a doctor will be covered. It’s critical for me as a physician to build trust with my patients by giving them clear answers. But the conversations we’re seeing now about health care remind me that insurance unknowns don’t just compromise the care I can deliver to my patients — they also undermine the fragile doctor-patient trust. It’s an unsustainable dynamic.