Ways to Reduce the Cost of Health Insurance: David Himmelstein

[eridani]

Run time: 05:44 https://www.youtube.com/watch?v=p-mpadKoFB4   Posted on YouTube: April 23, 2009 By YouTube Member: Views on YouTube: 0   Posted on DU: April 30, 2009 By DU Member: eridani Views on DU: 508

 
A Canadian hospital gets paid like a fire department does in the U.S. It negotiates a global budget with the single insurance plan in its province, and gets one check each month that covers virtually all costs. They don’t have to bill for each bandaid and aspirin tablet. At my hospital, we know our budget on January 1, but we collect it piecemeal in fights with hundreds of insurers over thousands of bills each day. The result is that hundreds of people work for Mass General’s billing department, while Toronto General employs only a handful - mostly to send bills to Americans who wander across the border. Altogether, U.S. hospitals could save about $120 billion annually on bureaucracy under a single payer system.

And doctors in the U.S. waste about $95 billion each year fighting with insurance companies and filling out useless paperwork.

Unfortunately, these massive potential savings on bureaucracy can only be achieved through a single payer reform. A health reform plan that includes a public plan option might realize some savings on insurance overhead. However, as long as multiple private plans coexist with the public plan, hospitals and doctors would have to maintain their costly billing and internal cost tracking apparatus. Indeed, my colleagues and I estimate that even if half of all privately insured Americans switched to a public plan with overhead at Medicare’s level, the administrative savings would amount to only 9% of the savings under single payer.

While administrative savings from a reform that includes a Medicare-like public plan option are modest, at least they’re real. In contrast, other widely touted cost control measures are completely illusory. A raft of studies shows that prevention saves lives, but usually costs money. The recently-completed Medicare demonstration project found no cost savings from chronic disease management programs. And the claim that computers will save money is based on pure conjecture. Indeed, in a study of 3000 U.S. hospitals that my colleagues and I have recently completed, the most computerized hospitals had, if anything, slightly higher costs.

Complete transcript here-- http://edlabor.house.gov/documents/111/pdf/testimony/20090423DavidHimmelsteinTestimony.pdf

[MrModerate]

1. Until health insurance companies (aka "ghouls") are driven out of the system . . .

Improvements will be seriously constrained. However, not trivial. In Australia, where I'm currently living, the state-provided healthcare exists alongside private cover. Private cover basically gives you quicker access to heathcare with a few more amenities, and most middle-class people elect to take private cover (which is not insanely expensive or restricted only to the healthy). But the existance of the public health system (subsidized by payroll deductions and tolerable but not inconsequential copays) both keeps costs in check and the insurance industry held down to a reasonable size. Also, the insurance companies can't buy politicians, largely because of the way both campaigns and campaign financing are run.

As an expat, I'm not eligible for free healthcare, but even then the cost of health services when I do need them is waaaaaay lower than for an equivalent uninsured person in the US (and once I jump through all of the useless hoops to make a claim back to my US-based insurance carrier -- subsidized by my US-based employer -- my overall cost is not bad).

Which is to say, it can be done, even in a mixed public-private environment.

[MedioGringo]

4. Ahh but does Australia have private for-profit proviers?

Or just non-profit private providers like Germany? If they are for-profit, can you give us a bit more information on what makes their system work and ours fail so miserably.

[MrModerate]

6. Not sure. Let me ask around. n/t

[lostnotforgotten]

2. The Truth - Stated Plain And Simple - Obama's Approach Is Not Sound

eom

[54anickel]

3. My niece works for one of the big health insurance companies. They outsourced most of their data

entry, as most of them do. We were just informed by our health care provider that if we ask the doc a question about a specific ailment during our annual check-up, it will now be charged as a separate visit. Seems the insurance companies have implemented a new system that cannot take multiple codes AND, for some reason, it is now illegal for a doctor to change a code? I remember years ago that code changes were fairly common practice in an attempt to the insurance company to pay. The codes were pretty confusing and overlapped similar procedures. I guess they've managed to get someone to consider it insurance fraud. :shrug:

I was just talking to a friend about this and she got the same letter even though she has a different insurance and clinic. Wonder if they're all using the same data entry provider or same software package.

[eridani]

7. That is one more advantage of single payer--we could flat out FORBID outsourcing n/t

[avaistheone1]

5. Bookmarked and Recommended.

That is why we should accept no substitute for single-payer universal health care.

:kick: