August 29th, 2011 | The Blog
Insurance bureaucracy is to medicine what a grand piano is to a patient with a broken leg- Nice to have, but hard to carry around with you every day. A recent study has discovered that doctors offices spend up to 21 hours a week simply grappling with insurance rules. This enchanting, archaic process often drags in nurses as well, so the real cost of that 21 hours, which is around 1000 hours per year, is staggering. The current estimate is about $80,000 per year.
Nor is the time usage the only issue. The New York Times explains:
A young patient complaining of extreme fatigue, for example, might benefit from a $40 blood test that could confirm infectious mononucleosis in 10 minutes. But a doctor cannot order the simple test without first checking with the insurance company to see if it is covered and if there are any constraints on where the patient?s blood can be drawn and the test run.
Just what the health care sector needs- More procedures, and thousands of them, for practically anything. The New York Times report cites Canadian medical practices as spending about a quarter of the time of their US counterparts on insurance processes. In Australia, insurance runs on rails- Procedures and processes are scheduled, and that’s that. Either a procedure is covered or it’s not, and it takes seconds to find the procedure on an itemized database. Australian insurers also don’t have the audacity to try to dictate standards of medical procedures.
In a sector where cost inefficiencies are pure poison, the US insurers are helping nobody. The requirement for sick people to travel to “approved sites” is cited in the NYT report, another exercise in dubious practicalities which also adds costs for patients as well as exposing them to possible stress in travel. Not exactly best medical practice, and hardly conducive to rest and peace of mind for the patient.
Doctors also complained about the sheer number of changes to health insurance rules. This is one of the oldest tricks in the book- Large numbers of procedures and rules mean a thriving bureaucracy. It also means that bureaucrats are the in-house authorities. so they dominate the system, which naturally becomes more bureaucratic and procedure-oriented over time.
Current recommendations are for simplifying the system and streamlining procedures, but there’s another option- Technology. It’s quite possible to create a standardized list of items and simply search it, taking at most a few minutes. The savings in time and money are instant. It also eliminates any ambiguities and cuts down on red tape.
Another good idea would be scrapping even the idea that health insurers can dictate medical procedures. Any service licensed to provide medical services should be considered prima facie acceptable parties for any process related to health insurance claims, as they are in the rest of the world.