Thursday, August 6, 2009

Government is not necessarily the problem?

I have heard that as much as one-third of health care costs are for administration. Paperwork.

I don't know now where I heard that or if it is even true, but I saw a doctor being interviewed on TV last night (can't remember his name, but he used to be Obama's physician) and he said that he had two full-time employees whose job was just to fill out paperwork for the insurance companies.

Another thing he said, which I found very interesting, was that the time-consuming part was not really the government Medicare stuff, as one might think, but the private insurance forms. He also said the government/medicare pretty much left him alone, and that the harassment and pressuring to lower his standards of patient care were coming from private insurance companies too, and not the government.

Well, if true, that is an eye-opener because I had always assumed that any nightmarish paperwork and regulations would be coming from the government. Not so, this doctor says, and he also says (because of that fact) he has no fears of a national health care program run by the government.

I am still digesting that, and, of course, one of my digestive enzymes is that he was formerly Obama's doctor, so I'm guessing the good doctor was born loving big government. Still, it is food for thought. I may be won over to this national health care thing yet. Still many questions to be answered.


Descartes said...

From what I can tell The National Health Care System is going to be much like the Mandatory Auto Insurance laws. You are going to be told you have to have a certain amount of coverage and it's going to up to you to get it.

I feel sure that all kinds of discount companies will appear offering nothing but the bare minimum policies.

I'm sure this will create a lot more jobs, just to deal with the paperwork.

Stephanie Barr said...

The attitude you document is in keeping with what I've heard from my own doctors and a few others I know personally. HOWEVER, I have heard other doctors say the polar opposite, including one my regular commenters. I favor a single payer system myself.

On the other hand, I'm not a doctor and I do agree that we're going to have to work to make sure doctors are still compensated for their expertise. But I feel strongly that the situation we have now is unacceptable.

Stephanie Barr said...

You know, this is a question we could probably get objective evidence on. For instance, one could find out how many practitioners take medicare vs., say, how many practitioners take BCBS. BCBS is a huge network, as RM noted, and it would make sense, if doctors were losing money on Medicare, they'd excise that portion of their practice (and it also goes to answering the "will we have big drop in available doctors?" If we want to know if we have choice, this evidence should be available.) Bear in mind, there are administrative costs not only in the doctor's office but also at the insurance/medicare offices. I've heard that medicare's administrative costs are a fraction of those at private health insurance, but it should be something that could readily be verified - all this aside from the profit question.

I'd like to compare medicare's per patient cost (actual health reimbursement) vs. private, but, unfortunately, since Medicare doesn't exclude preexisting conditions and exclusively covers the elderly, such a comparison is unlikely to be meaningful (unless Medicare's is lower in which case something is desperately wrong with private insurance).

However, medicaid is focused on the poor and children and might be a reasonable comparison per/patient, to private insurance.

Personally, I think the arguments for and against (and the often emotional "issues" brought up on any side of the issue) could be readily addressed with just a few hard facts.

Relax Max said...

@Descartes - I hope not. God.

@Stephanie B - Maybe all the paperwork can be on computer online with the government insurance ummmm.... thing...

You know, like your medical records? For the world to see?

Good idea to get some real facts for a change too. Too much is just speculation and guesswork.

Stephanie Barr said...

Dull reading if they want my medical records. To be honest, the organization most likely to use my medical records against me is my health insurance company and, hey, I have to let them have them.

I bank on-line and, hey, that information is much more likely to be useful to someone than my medical information. And, yet people don't talk about taking that away...

A. said...

Some of the problem is caused by progress. As medical science makes more and more advances, treatments and procedures become more complex. When the British (rather than UK, in deference to Janet) National Health Service came into being, there were no lengthy cancer treatments, no complex heart surgery, no transplants, no HIV, no IVF. It's hardly surprising that the NHS struggles to make ends meet as the costs soar. The drug companies are often blamed, and although I don't like some of their enthusiasm in developing drugs aimed at wealthy nations, they aren't the sole problem.

Unknown said...

I have a Doc's appointment today. I am going to ask about some of these things. Paperwork and such. It's for research right?

Janet said...

A - :)

The Mountain Man and I both had bloodwork done recently testing a variety of things. One of those was creatinin levels. When we checked our EOBs, the charge for mine was about $12 and the insurance company allowed $8. The charge for his was $45 and the insurance company allowed $18.

We had gone to two different labs. The first lab does not bill for what the insurance company doesn't cover. The second one (which is the local hospital here) does. The Mountain Man is still trying to get the insurance company and the hospital to straighten that mess out.

So that's an example of private insurance, for what it's worth.

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