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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: TimF who wrote (6195)	2/26/2009 10:05:09 PM
From: i-node	Respond to of 42652

That brings up an interesting point, people claim that government insurance such as Medicare is more efficient, but Medicare used private companies for processing. Even if the government was more efficient than the private sector in this area (a dubious idea IMO), how would private companies become more efficient because they work for the government? It is a good point. Here, the contract is held by "Pinnacle Medicare Services", and they process claim for about five states. It is an absolute disaster. Previously, the contract here was held by BCBS. Over the last 10 years I've seen the level of service drop from bad to horrible as the demand for more EDI services has increased. I developed one of the first provider-end EDI systems installed here (in the mid-80s, using bi-sync, no less) and I've seen the changes. It just gets worse every year. While Pinnacle is a private company, they have the look and feel of a government bureaucracy in every respect. Having spent about the same number of years dealing with the IRS as I have with Medicare services, I can honestly say Medicare Services is worse, at least in the states where we work. I think the problem is that everything is done according to statute or regulation. There is absolutely no flexibility or agility in the business because they do what the law requires them to. Or at the very least, they can blame anything on it. It is just a huge bureaucracy and I have no idea how people function in that environment or how you fix it. I don't believe it is a good idea to expand their scope, though. I'm a small company kind of guy. I could never function in that environment.