Op-Ed: The System Isn’t Broken—It’s Working Exactly as Designed By Dr. Tim Peck, Emergency Physician and Candidate for Congress (IN-9)

The following was shared with the Bloomingtonian:

By Dr. Tim Peck, Emergency Physician and Candidate for Congress (IN-9)

Last week, Indiana Governor Mike Braun signed a package of 10 healthcare bills into law. Some of them I strongly oppose—especially the one that requires sick people to work in order to qualify for Medicaid. But many are steps in the right direction: increasing price transparency, reducing anti-competitive practices, and protecting patients from surprise billing. For that, the Braun administration deserves credit.

What has happened in Indiana isn’t just a series of isolated problems—it’s the result of a decades-long arms race between insurance companies and healthcare providers. The rest of us—patients, nurses, doctors, and families—are the collateral damage.

Since the 1960s, payors have built systems to avoid paying for care. So providers built systems to make sure they get paid. Then payors fought back with new tools to deny payment. Providers responded with tools to optimize billing. On and on it goes.

We now have a bloated system filled with prior authorizations, billing departments, electronic medical records designed for reimbursement, prescription delays, insurance denials, and hospital consolidation—not because they improve care, but because they give an edge for one company to make more money than the other.

The patient always loses.

Waiting weeks for an MRI while the doctor’s office faxes appeal letters. Getting a surprise bill for a service you thought was covered. Arguing with your insurer about a medication you’ve taken for years.

None of this is a fluke. It’s all by design. One side is paid to deliver more services. The other is paid to deny as many services as possible. This misalignment is built into our fee-for-service system—where doing something, anything, gets paid, whether it helps or not.

Governor Braun’s new laws chip away at some of these problems, and that’s a good thing. But if we want real change, we need to redesign the system itself.

Imagine if everyone—doctor, nurse, insurer, hospital—got paid based on whether you got better, not just whether a service was rendered. Imagine a system where the goal wasn’t more procedures or fewer procedures, but better outcomes and a better experience.

That’s a person-centered, value-based system. It’s not a fantasy. We’re already seeing it in models like direct primary care, where physicians are paid a flat monthly fee to care for patients comprehensively—and spend more time with them, not more time on billing. We see it in federally qualified health centers, which bring medical, behavioral, and social services together under one roof to reduce ER use, lower costs, and improve outcomes. We should support and scale these systems to provide better care to all Americans.

Our healthcare system isn’t broken; it’s working exactly as it was designed. That’s the problem. And it’s time we had leaders with the courage to redesign it—around people, not profit.

The post Op-Ed: The System Isn’t Broken—It’s Working Exactly as Designed By Dr. Tim Peck, Emergency Physician and Candidate for Congress (IN-9) first appeared on The Bloomingtonian.