Insurance companies exploit doctors like an abusive partner exploits a spouse, the speaker argues. Both cling to a harmful relationship hoping it will change. The healthcare payment system is built on power imbalance and extraction.
People believe that the bad relationship is going to change because they want it desperately to work. They want desperately for the bad relationship to work. This sounds exactly like the relationship that exists between insurance companies and doctors. You see, in this story, the insurance company is the abusive husband, and the doctor in this story is the sex worker/prostitute or the abused spouse.
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