From: robgood@bestweb.net   
      
   On Wednesday, January 20, 2021 at 3:12:36 PM UTC-5, Questor wrote:   
      
   > 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.   
      
   What makes you think they wouldn't?  No matter who does the paying, there'd be   
   a need to control costs by paying for certain cases   
   and not others.  That's going to require the same people to look at each   
   service and each potential service and decide whether it is/was   
   needed badly enough, as against whatever policy is adopted.  Nobody's ever   
   going to pay unquestioningly for everything, and people are   
   going to push up against the limits of whatever policy is adopted.  It can   
   never be reduced to a simple no-judgment formula, because   
   medicine always involves judgment.  Nor can you let the person getting paid   
   have the last say as to that judgment.   
      
   Bob in Andover   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)