Insurance Hassles Killing Off Family Docs

[Joanne98]

by John Brady

I love being a family physician. I love the history rooted in the country doc who did his best to help comfort and heal his neighbors. I love the broad scope of practice where I am always seeing something different and something challenging. But most of all, I love the long-term relationships with my patients. So it is with a heavy heart I admit that my specialty is dying.

This matters not because of the nostalgic loss of the way things were; it matters because studies have proved the essential foundation of a less expensive and higher quality health-care system is effective primary care.

Specifically, as primary care dies, access becomes limited, waits become longer and costs soar.

With this silent but looming crisis becoming ever more evident, we have to take an open and honest look at the reasons for the demise.

We are dying because of an insane payment system. Primary-care doctors mainly get paid for visits to the office, with each visit having its own particular insurance code. Although this sounds straightforward, every insurance company pays different amounts for different visit codes, and every patient has his own individual deductible and co-payment, so no one knows who owes what or what the final bill will be until the insurance company signs off weeks to months after the visit.

The process of getting paid is so complex it has spawned an entire industry dedicated to medical collections. But getting paid for visits also forces doctors to jump on the treadmill of seeing patients to fill their schedules.

Even one open slot is lost revenue, so patients who have something which could possibly be handled over the phone or through e-mail are forced to come in for a visit.

Schedules become packed and inflexible, leading to physicians who are harried and insufficiently empathetic and patients who are frustrated from hours wasted waiting for a five-minute appointment. The resulting chaos, due directly to the payment system, is unhealthy for everyone.

We are dying under the weight of useless administrative paperwork. To try to save money, insurance companies have begun to request prior authorizations on everything from medications to radiological procedures to seeing specialists.

This shifts additional administrative costs to the doctor's office, making the treadmill of patients run even faster.

Continued>>>
http://www.commondreams.org/view/2008/12/31-4

[katusha]

1. See Also "Insurance Hassles Killing Off Families"

http://www.michaelmoore.com/words/latestnews/index.php?id=12875

[customerserviceguy]

2. My last job was for a company that supplies

endoscopy equipment. Our pricing structure was so Byzantine, we had a whole department to figure out just what to charge a given facility for our products when they requested a quote. Purchase orders that came in from customers were often wrong as to "their" price, and had absolutely NO standardized form. We didn't even make it possible for customers to order routine supplies for our products over the Internet.

I only worked there a year, but I saw a whole system dedicated to the perpetuation of extreme inefficiency.

Is the health insurance industry any better?

[AnnieBW]

3. Duh...

My favorite of the three GPs in the office that we go to retired rather than deal with the insurance and rising costs of doing business. I really miss him.