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

To: skinowski who wrote (6850)	6/1/2009 12:04:58 PM
From: John Koligman	Read Replies (1) \| Respond to of 42652

Obama sees a window now, and if the Republicrooks get some power again the thing will simply go back into deadlock for another generation. I can see them going back to their 'small government' tax cut mantra... By the way, perhaps some of those high costs are the profits and salaries of private firms, as I posted <ggg>... In the end there might have to be some rationing of care, especially heroic end of life efforts, and doctors/the health care complex is going to have to take some cost cuts. Why, maybe even the drug companies can take a hit, they didn't get those fat market caps from creating low profits.... John

To: skinowski who wrote (6850)	6/1/2009 1:41:47 PM
From: i-node	Read Replies (1) \| Respond to of 42652

It occurs to me that simply changing the method of paying, like from private to public, would not do the trick. The argument that it is the "payment system" causing all this inefficiency is silly. While there is undoubtedly some duplication of effort (e.g., software development for each carrier's claims processing facility), these inefficiencies are minimal compared with that of government payers. As an example, in our state it currently takes 6 months for a provider to get enrolled in the Medicaid program (a time during which new providers are totally reliant on patient copays and whatever they can collect from commercial insurers to keep their doors open). Medicare, end-to-end, is taking just under six months. No commercial carrier I know of requires this kind of lead time. Now, this is a problem but not a massive one -- but it is indicative of the kind of bureaucracy you're dealing with in government programs. Another example is that Medicare services STILL cannot accept claims by Internet. When you submit claims to Medicare, you submitting via plain-old 56k modems. One could argue, "Well, this is where we're going to get savings -- we're going to make Medicare more efficient and modern". But the reality is that were it that easy, it would have been done long ago. It is going to take legislation to make that happen, or at the very least, aggressive regulation, which isn't about to happen. (To submit claims to Medicare, you literally have to dial in to an old-fashioned, 80s-era "bulletin board" to submit your claims -- of course, clearinghouses do this dirty work for us, but still. It is insane.) Most commercial carriers, like United Health or Cigna, offer a variety of ways to submit claims -- paper, electronic via clearinghouse, direct submission or web-interface. But government just can't figure this out.