Last fall as the health insurance “open enrollment” period approached, Corewell Health was fighting a battle with United Healthcare. Corewell sent out a set of “talking points” including a recommendation to suggest patients insured by United seek out other insurance plans to avoid disruptions in their care.

And now Michigan Medicine is in a fight with Blue Cross/Blue Shield. Like the United customers at Corewell, BCBS customers will soon lose access to the University of Michigan medical system.

These fights are obviously bad for patients, but they also reveal a fundamental ignorance on the part of healthcare systems and insurers. The underlying assumption is that people can simply change health plans the same way they might choose gas stations or supermarkets. But almost half of all Americans get their health insurance through their employers. They don’t have any say in what insurance company they use.

It’s deeply disturbing that our major healthcare systems should be so ignorant of such a basic fact. Trying to get patients to fight for them is not a thing. When insurance companies and hospitals fight, the only people hurt are patients. The suits up in the C-suite will be just fine, but real patients will lose vital care. These fights will break long-standing relationships between patients and doctors, but more important, people will be denied specialty care that might only be available at a hospital that no longer takes their insurance.

Insurance companies seem to believe that patients can simply chose another hospital and hospitals seem to believe that patients can simply choose another insurance company. None of this is true.

What this reveals are the fundamental flaws of our healthcare system. We have what amounts to socialized medicine for people over 65—Medicare does an excellent job, more or less, of providing insurance for our seniors. Then we have insurance that is tied to our employment—if you don’t have a full time job, you don’t have insurance. Medicaid—government-sponsored insurance for the poor—is very limited, and individually-purchased plans are unaffordable.

So hospitals and insurance companies can fight all they want. But leave the rest of us out of it. The only power we have in this fight is the vote. Our power will only be revealed when we choose leaders who really care about healthcare reform.