B-school for HMOs

It seems to me that the state of medical care in the US can best be described as parlous. This article agrees, "The problem is that the competition that developed in health care was the wrong kind, with each interest trying to use, and add to, its market power for leverage - a zero-sum competition that is not really focused on value. Instead, the system ought to compete at the level of individual conditions and treatments, with providers and payers vying to produce the best outcomes for patients."

Doctors have lost control; instead of being care givers they instead have become gate-keepers. They have on staff (at least) one employee whose sole task is to obtain "authorizations" from the various medical plans (HMOs, PPOs, POSs, etc) before any diagnostic care can be done, leave alone prescriptive attention.

Two personal examples:

1. I have suffered a chronic pain in my left arm for the past 38 months. I thought losing weight and improving my physical condition would attend to that pain; alas, no. My doctor (primary care physician, or PCP in medical insurance jargon) is confident he knows the cause, but he first must receive permission before referring a specialist. Once obtained, the specialist also must receive permission to perform the various tests to confirm the cause. Then the specialist again must obtain permission before taking care of the problem. Meanwhile, I remain in pain.
2. I take a statin for elevated cholesterol. The specific drug, however, that would help my condition is not covered by the insurance company's formulary; thus, for the past 9 months, I have had to endure the 'game' of an increasing dosage of the statin the insurance company does cover just to prove its inefficacy... while the patient's (my) life is in danger.

You can regale me with fine tales of how you were spared the ignominy of undiagnosed pain or spared death thanks in part to your health insurance. I would argue your story is the exception rather than the rule. Something is rotten in Denmark, as the article attests. HMOs, once regarded as savior of the entire industry, arguably are the largest contributor to the systemic problem. There is a failure in the system that lies somewhere between employer-sponsored health coverage, health insurance, doctors, and the patients. We each must give something to achieve balance.

I believe the system, as it is currently configured, is broken. What do you think...?