From: usenet@only.tnx   
      
   On Sat, 16 Jan 2021 19:11:32 +0000 (UTC), Howard  wrote:   
   >Boron Elgar  wrote   
   >> The system just had   
   >> to figure out how to properly monetize it all.   
   >   
   >It seems possible that's a big driver.   
   >   
   >I was really bothered to find out that probably the biggest reason   
   >behind problems with shifting the medical system to electronic record   
   >keeping and data sharing was the insurance side of it.   
      
   Twenty years ago, I worked on an IT contract doing Y2K remediation at a   
   hospital.  More accurately, a hospital system:  two hospitals, a small office   
   tower, and a dozen or so other small offices of practioners scattered in the   
   area.  My work took me anywhere they used computers, which was just about   
   everywhere.  (And today it would be everywhere.)  It gave me an exceptional   
   view into the workings of health care.   
      
   After nurses, doctors and other groups of medical professionals, by far the two   
   largest departments in the system -- dozens of employees -- were the ones   
   dedicated to the recording, coding, transmission, accounting, and billing for   
   every action taken on behalf of a patient.  It's a very complicated and   
   byzantine system, and it exists in large part only to determine who pays how   
   much for what.  Apart from keeping a record of treatments administered, it does   
   not contribute to patient care.   
      
   Why does the U.S. spend one-sixth of its GDP -- two to three times that of   
   other   
   industrialized nations -- and still has worse health outcomes and doesn't even   
   have universal coverage for all its citizens?  In an over-simplified nutshell,   
   it is because in America we spend our money on health *insurance*, not health   
   *care*.   
      
   Insurance companies generally do not provide patient care.  They do not see   
   patients, conduct tests, or perform operations.  They are middle-men, inserted   
   into the health system between the payers (employers, government, individuals)   
   and the care providers (medical professionals).  Absent strong government   
   regulation in the U.S., they have continued to siphon off more and more of the   
   dollars meant for health care and used it to support their own bureaucratic   
   structure.   
      
   I'm not wedded to single-payer as a solution, since there are examples of   
   industrialized countries where their multiple-payer system is effective.  (It   
   still requires strong government regulation.)  But single-payer does seem like   
   the obvious system to simplify health insurance.  The problem, and the   
   resistance, comes from the thousands of clerical workers, medical analysts,   
   etc.   
   who work at insurance companies and the hospitals.  Most of them would no   
   longer   
   be needed.  There would be a tremendous re-structuring of the health care   
   sector.  That's a huge impediment to reforming health care in the U.S.   
      
      
   >Having doctors   
   >record their diagnoses, collect test results, issue prescriptions, and   
   >all of that wasn't a huge challenge. For the hardcore anti-tech   
   >oldtimers, that stuff can generally be handled by handing notes and   
   >recordings off to third parties.   
      
   Not necessarily.  See elsewhere in this thread.   
      
      
   >It wasn't even the privacy issues -- it was the fact that the   
   >documentation had to conform to billing specs in order to justify   
   >decisions that needed insurance reimbursement.   
   >   
   >Digitizing the patient-provider and provider-provider sides were   
   >challenging but manageable, but the patient-insurer and especially the   
   >provider-insurer parts were (and still are) a nightmare.   
      
   --   
   Warm winds blowing... heating blue sky... and a road that goes forever...   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)