July 07, 2009

Healthcare Sanity

This whole issue goes back to there is no methodology to pricing in healthcare. There used to be, back in the day. You went to see the ol’ Doc and he gave you a bill. Doctors today do not even know what they charge, if you ask a doctor what it costs for a simple procedure they have no idea. My company’s dental plan has a list to say what they will pay for each procedure. If they say that they will pay $100 for an extraction, and my dentist charges $120, I know I owe $20. But If I go in to the doctor for a checkup, I pay $25 for my copay, and then all kinds of gyrations have to happen between the Dr office, the Clinic, the hospital, my insurance, my employer, me, etc. Meanwhile I have no idea what an office visit actually costs. A lot of the costs a Doctor incurs are associated with Billing and Insurance. SO it costs the Doctors a lot of money just to bill and get paid for their services. The problem is no one knows what it costs. The Dr. doesn’t know, the patient doesn’t know, the insurance may know, but they aren’t saying. How will the American people know if any reform is saving them money if they do not know how much it costs in the first place? Not only do I not know what my Doctor charges, I do not know what my insurance costs. I know what gets withheld from my check, but my company also pays MOST of the premium. This is a ludicrous system, and the government is only trying to make it more complicated.

The biggest problem with our system is the Insurance stands between the patient and the doctor. This is not how car insurance works, this is not how home insurance works. How cool would it be if before you had a knee surgery you got three estimates, or if you just got a quote from your doctor, and then compared that to what your insurance said they would pay for that procedure? Then at least you would know. What if the insurance cut you a check like homeowner’s insurance does when you need a new roof? Let me make a claim and get my money to pay my doctor.

What if your company disclosed what they paid for your premium so you would know what it cost? What if Doctor’s had to disclose their prices? What if the Government had to pay the going rate instead of whatever they choose for Medicaid? The idea that the Government will dictate prices is BAD. Bad idea, government dictating prices always causes corruption and loss of service.

The insurance should be the backup for the patient, not the parent, negotiating and paying the bills. A person’s medical care should be an informed decision. But everything in our system is set up to ensure that we aren’t informed. *gasp* it should be an issue of personal responsibility and freedom.

I agree totally with the administration, the whole system is BROKEN. That is where our agreement ends. The broken part of the system is that the doctors and the insurance companies are engaged in trench warfare and the casualty is the patient. Insurance is largely a racket. Doctors are less concerned with patient care in many cases than they are about waiting room turnover, time management, and making money. Lawyers get involved in the mess too, as Doctors are terrified of making any mistake whatsoever. But to suggest that the government can FIX anything is ridiculous, ludicrous, laughable, and absurd. Government does not fix anything, and they do not produce anything. Government will not increase competition OR keep anyone honest. That would be like an alcoholic keeping people out of the liquor store. What Government knows about honesty could fit in the period at the end of this sentence Notice I didn’t put a period at the end of that sentence. Government reduces competition, and increases corruption.


Does this look like a reasonable process flow?

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