Wednesday, March 30, 2011

Health Policy Rant

One radom point that I would like to make is that I find health policy types never seem to question one of the underpinnings of the current system, namely that it is predicated on 3rd party payments, and its role in hampering innovation and cost control very frustrating. When you walk into your physicians office what should be immediately obvious to you is the substantial overhead costs involved with navigating this system. Even a simple practice will often have a billing department with several staff. This entails significant direct costs in the form of PC&B but indirect costs in the form of higher rent and the ability to see fewer patients as the doctor now also is managing a more complex operation. The conventional liberal response to that is "a-ha, single payer will make this go away". Well, not entirely, you would still have to chase reimbursements but now only from uncle sam. So you could let off some staff but you would you would still have a significant amount of overhead. There would be savings but not as much as one would think. Whereas if you simply paid when you received the service the avearge practice could probably make do with a support staff of one- a scheduler/bookkeeper. That is a small example but one that I think is accessible to most people as it is the extent of our normal interactions with the health care system and it is obviously inefficient.

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