Mike Littwin writes on his experience with Type 1 diabetes and the health care system in the Post.
Health care reform is incredibly complex. I’ve talked to doctors and others in the health care field who worry that the politicians will get it wrong. But it’s rare to meet one who thinks what we have today works.
On Monday, I met Dave Gans, a vice president of the Medical Group Management Association, which represents doctors’ practices. We were at a gathering at St. Joseph Hospital where U.S. Sen. Michael Bennet was talking health care.
Gans had worked on a study showing that doctors spend an average of approximately $60,000 a year dealing with insurance companies. That would be approximately insane. You know why costs are so high. It’s not only inefficiency and paperwork. It’s that insurance companies make money by making it hard for doctors to make successful claims.
I’ve seen numbers that show insurers turn down as many as 30 percent of claims. I heard doctors explain to me what it’s like to be in a small practice. Say you have a $100 claim and say it costs you $25 to file a claim, another $25 to appeal when it’s turned down, another $25 to appeal a second time and so on. How long before you decide not to appeal at all? And that’s before we even get to the issues of reimbursement for Medicare.
And, of course, there’s more here at work than cost. If you lose your job, you lose your insurance. If you have a pre-existing condition, you can’t get insurance. If you have an expensive disease, you can run into a lifetime cap. If you have an expensive disease, your insurer may spend many person-hours looking for a way to exclude you (including the now-infamous case of the nurse with breast cancer denied care because she failed to tell her insurers she had once been treated for — I know I’ve used this one before — acne).
“We have the best health care in the world,” Gans said. “And we have one of the worst health care systems.”
It seems like a paradox, but it isn’t. It’s how we can spend so much — much more than those peer countries with universal health care — and yet have outcomes that rank us well below those same countries.
“We have a dysfunctional system,” Gans said. “No one would have designed this system. We have excellent providers. We have excellent institutions. We have a system that wants to work.”
He pauses. “But doesn’t work.”
Update: Alternet has a good article on why our health care system sucks, including some interesting stats:
- The WHO ranks the US health care system 37th in the world, behind Portugal and Columbia;
- The US ranks 44th in the world in infant mortality;
- Out of 30 developed nations, life expectancy in the United States ranks 21st; and
- More than 50% of Americans have medical debt problems.
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