Re: Be afraid, be very afraid Health Info

[David Farber <dave () farber net>]

Begin forwarded message:

From: "David P. Reed" <dpreed () reed com>
Date: April 7, 2009 7:20:09 AM EDT
To: dave () farber net, Karl Auerbach <karl () cavebear com>
Cc: ip <ip () v2 listbox com>
Subject: Re: [IP] Re:    Be afraid, be very afraid Health Info

Karl - the idea you propose is a standard that could be used to  
organize many of the activities being proposed to make health care  
affordable.  Call it "single estimate, single bill" - analogous to  
single payer - and it has a nice "bipartisan" political soundbite to it.

It's far from "shovel ready" though.  To achieve that goal requires  
nothing less than a vast restructuring of the entire health economy -  
all of its institutions.  Perhaps we could have the ribbon cutting in  
one year, and the new structure would be complete in 2025.

Why?  The answer is that all of that inconsistent billing and  
reimbursement is embedded in the contracts between insurers and  
employers, insurers and providers (my wife, who is in private  
practice, has 7 separate contracts with 2-3 varieties of patients  
covered by each, among the "panels" on which she has been qualified to  
serve), and in a complex set of regulatory rules that often seem as if  
they were designed by Kafka for an unwritten novella called "The  
Procedure".

That contracting structure has a life of its own.  It cannot be  
destroyed by a tiny uprising of citizens with shovels attacking Dr.  
Frankenstein.


David Farber wrote:
> It strikes me, as one who has gone through some medical events of  
> late that that there is a very inexpensive and easy thing that could  
> be done immediately - it's "shovel ready".
>
> And that would be for the medical system to give patents clear  
> statements of prospective costs before a procedure and a clear  
> statement of actual costs after a procedure.




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