The Health Catastrophe

Posted by: eric on June 25, 2009 at 6:32 pm

There has been a lot conversation lately about the need for healthcare reform and we are at a pivotal point in the ongoing debate.  Despite all the press coverage on healthcare, one in five do not know whether to support Obama and the Democrats’ plan. But I believe one thing is clear, continuing the status quo in healthcare is not acceptable and not sustainable.

In the countries of the developing world, persistent poverty is the main culprit behind the lack of good healthcare. But in the United States, poverty can’t be blamed for the failure of the healthcare system. Somehow we can’t manage to provide decent-quality healthcare to millions of our citizens, despite the billions we throw at the problem.  Why not?

Many thoughtful analysts have examined the problem, studying the history of healthcare in the United States and comparing our jerry-rigged “system” to the delivery programs provided in most other countries of the developed world. Most objective observers point to the same root problem: our profit-driven medical system, which channels a huge percentage of healthcare expenditures to insurance companies, for-profit hospital chains, giant pharmaceutical firms, and other businesses, while shamefully neglecting “unprofitable” services and patients.

As a result, an estimated one-third of U.S. healthcare expenditures are wasted on “ineffective, sometimes unwanted, and often unproven procedures” (according to Jack Wennberg, M.D., director of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School)—simply because that’s where the profits are.

An even more shameful waste is the third of healthcare spending that goes to administration and overhead—filing of insurance claims, the back-and-forth of denial and adjudication, bureaucracy, red-tape, and supporting redundant parts of the medical infrastructure. Hence, only one of every three healthcare dollars is being spent wisely, a waste of almost 500 dollars per year per person in the United States.

American members of Generation We inherit a world of technological marvels and a nation with resources unmatched in human history. Yet thanks to decades of greed, mismanagement, plundering, and leadership distorted by rigid ideology, they also inherit a health system that is simply broken—one that may prove unable to treat them for the man-made diseases inflicted upon them or to protect them when the predictable next wave of diseases strikes some time in the next decade or two. There’s a real and frightening danger that the healthcare enjoyed by recent generations of Americans may disappear by the time Generation We reaches old age.

3 Responses to “The Health Catastrophe”

  1. Gloria Ulmer Says:

    I agree and more often than I want to remember I had to deal with the above statements, specially with the 5h paragraph
    “…filing of insurance claims, the back-and-forth of denial and adjudication, bureaucracy, red-tape, and supporting redundant parts of the medical infrastructure…”

    During the past 20 years and after many back-and-forth litigation’s issues between insurance company and the medical infrastructure, I have spent hours and days rewriting my PAID insurance allowances, coverage, etc. to no avail.
    All because the medical infrastructure did not fill out the claim EOB correctly.
    Until I learned to threaten the insurance companies in question the same way as they threatened me with ‘reporting me to the credit bureau’ They were using ‘knowingly or unknowingly’ false statements to threaten me but my response to them was stating their fraudulent accusations with a copy of the same to the Federal Health Insurance Department for their violation of my contract.
    In many instances the response from the insurance company had been:
    “sorry but your doctor’s office did not fill out the claim correctly and it has to be refiled”
    Also many doctors offices would not receive the payment for their rendered services due to the long process by the insurance companies.
    In reference to this slow payment process the insurance companies explain to me that their billing was being processed by a third party.
    This ‘third party’ entities take up to three months to pay the agreed amount to the health provider.
    Therefore many health providers do not accept certain insurances anymore

  2. Gloria Ulmer Says:

    I am almost convinced that insurance companies have their ‘shares’ out for grabs to the highest payer in the market
    A similar approach or the same as with the credit card companies

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