So why are we still letting the private insurance racket gum up the works of our health care system? The American Medical Association issued its first National Health Insurer Report Card this week, and the representatives of the "free" market come out looking pretty bad:
UnitedHealthcare had the lowest rate of contract compliance, according to the AMA report. About 62 percent of medical services billed were paid by UnitedHealthcare at the contracted rate, compared with 71 percent for Aetna and 98 percent for Medicare [Carla K. Johnson, "AMA Issues First Report Card on Health Insurers," AP via Yahoo, 2008.06.16].
What's that? The federal government pays its bills and complies with contracts better than private health insurers? The devil you say!
The private insurers' spinpeople try to shift the blame to the doctors. Laggardly UnitedHealthcare cites a "significant lag time between when services are provided and physician claims are submitted." But if such lag time exists, is there any reason doctors would be submitting their claims faster to the government than the private insurers?
The reality is that when doctors seek payment from Medicare, they aren't dealing with private profiteers who try to delay payment and keep funds in their own bank accounts to earn interest for themselves as long as possible. They're dealing with a government agency whose primary obligation is to citizens and the law, not shareholders.
Doctors spend "14 percent of their total revenue to simply obtain what they've earned," says the AMA's Dr. William Dolan. That's enough to drive some doctors to do what the whole country should do: ban private insurance!
Four years ago, Dr. Marcy Zwelling got so frustrated with the time and cost of making sure she was paid accurately by insurers that she stopped dealing with them. She now runs a so-called "boutique" practice. Most of her patients pay her an annual fee out of their own pockets.
"The best thing is, I get to be a doctor" instead of a claims processor, said Zwelling, of Los Alamitos, Calif. She says she doesn't make any more money than she did when she accepted insurance, but she has more time with patients [Johnson, 2008.06.16].
We have the rest of the industrialized world operating under some sort of national health care plan, spending half as much as the U.S. per capita on health care, and achieving comparable health outcomes. We have small operators like Dr. Zwelling getting out of the private insurance racket, creating true free market conditions for patients, and improving quality of service. Whichever direction we take health care reform, it's pretty clear that eliminating private insurance is part of the solution.
Unfortunately the problem with your argument is that Medicare can force everyone to paid for their service whether or not an individual wants to participate in it. Although I get absolutely ZERO benefit from Medicare, I am forced by law to pay 3% of my income into the Medicare system. If all of the private insurance companies were able to steal my money, I'm sure they would probably not be too concerned about minimizing costs.
ReplyDeleteThe fact that medicare pays all of their bills all the time without ever asking any questions is only proof that Medicare pays too much for the care that doctors provide. At least private industry is concerned about minimizing cost for the consumers so that consumers will sign up for their service and VOLUNTARILY give them money.
Tell me Cory, Do you -really- want the Canadian health care system?
Yes.
ReplyDeleteMe, too. Sign me up today. I was part of the biggest socialized health care system in the US - military health care. I'll take it in a New York minute over the greed-based, insurance run, "private" not-so-free market nonsense.
ReplyDeleteNative Americans get free health care, don't they? And they are still complaining. Evidently that's not working too great!
ReplyDeleteI agree with Matt about Medicare. I'm self-employed, and having to pay Medicare, SS, and income tax amounting to about 30+% of my check really gauls me. If I die before I reach Medicare age, the gov't has essentially stolen my money because I will never get a penny's worth out of it. Same thing for SS.
Not to mention that the gov't has already stolen my SS contributions for their general fund. Wonder what would happen if I just gave the gov't an IOU every month instead of my actual tax money? Ha!! Actually in that case, I think the gov't would be very efficient in demanding their due and meting out the appropriate punishment!
Nonnie
I've never even been to Canada, much less gotten sick there; so I can't compare their health-care system to ours.
ReplyDeleteNonnie, I too am unhappy about the way the government has raided Social Security for the general fund. If we had a "dedicated health-care tax," how do we know the government wouldn't raid it for the general fund, too? But then again, our government -- of, by, and for the people -- is behaving like most of us do when it comes to finances. Put in a fudge factor when things don't add and subtract quite right, and then blame someone else when the fit hits the shan.
If I die before I can collect any Social Security, I suspect I will not care one way or the other whether I got a square deal. My attitude has been more general and philosophical: If I have a comfortable place to live, food enough, and am able to keep doing the work I love for another 50 years, I'm not going to have much else to say besides "God bless America."
If costs really do go down with socialized medicine (as they arguably should), we all ought to be better off because any tax increase will more than offset the elimination of premiums to the insurance companies. That's the theory. Will it work in this hurly-burly real world? You tell me!
With our system of health care, I feel a little like I'm walking on a high wire without a net. There is no guarantee, after all, that if I become seriously ill, the insurer won't try to get out of paying. In fact, its a pretty good bet that they will try, motivated all the more by the fact that I'll be weakened by my condition, perhaps mentally incoherent, and therefore less able than a healthy person to wage war. That's not health care. That's social Darwinism.
Medicare and Medicaid do not over pay. Ask any doctor or hospital, those "high paying" government reimbursement rates are not great. This is why some doctors do not participate in the government systems or limit those patients-they lose money on them. Private insurance pays better which is why the hospitals staff a people to deal with them.
ReplyDelete