Web Letters: How Can We Get Healthcare For All?

We all absorb the graphic, disgusting tales of greed, waste, intentional fraud in the insurance industry. We know about the insurance industry's mind-altering propaganda machine and the hallucinogenic effects of the money it deals to Congress and the media.

Yet we all know the underlying story is that it's nonsense to have the health insurance industry in the middle at all. We all know that Medicare works. Medicare for All, a strategic, simple and economically sound plan is embodied in a bill called “HR676” and dubbed "single-payer." But as every progressive Congressperson drinking the insurance industry Kool-Aid will tell you, it doesn't have the votes to pass.

So, if Congress keeps insurance companies in the loop regardless of the sense it makes, then Congress could mandate something that would significantly reduce costs for healthcare providers: a universal billing and reimbursement clearinghouse. If it were mandated to be financed, created and maintained by the insurance industry, there would be no direct costs to the taxpayer.

A significant administrative burden for any healthcare provider is getting reimbursed for services. One regional, non-profit community health network, for instance, has to deal with over 120 different billing paths--for insurance companies, Medicare, Medicaid, walk-ins and sliding scale patients--because they are obligated by their non-profit status to serve everyone. Each insurer and federal, state and county agency requires unique forms and billing procedures.

Up to 20 percent of a provider's budget goes to billing and reimbursement. That's why private providers, HMOs and group practices accept only certain insurance options and refuse to handle patient coverage from other insurers.

Why does a doctor have to send a different form to each different insurance company--including Medicare and Medicaid--for each individual patient's annual checkup, S-ray, blood test, flu shot or treatment? Why should there be any difference in diagnosis, treatment protocols or reimbursement based on individual insurance company reimbursement schedules?

Consider ATMs, credit cards and returnable containers. Do you put your Bud, Coke, Pepsi and Heineken returns through separate machines at the grocery? Do Gap, your movie house, the MTA, Wal-Mart and Appleby's have separate registers for VISA, MC, Discover and gift cards? Do bank ATMs refuse other banks' ATM cards? Ever heard of UPC?

If Congress's ultimate "plan" does include insurance, why not at least require a universal billing and payments clearinghouse to process all healthcare claims uniformly regardless of carrier or agency? Besides reducing costs to healthcare providers and removing a road block for implementation of standardized electronic health record data, such a clearinghouse would report charges, payments, services and outcomes to Health and Human Services.

Among other things, the data from such a system could be used to assess the true costs and quality of healthcare across the country, practically in real time.

If our taxes are going to finance healthy profits for the insurance industry, let’s at least get some kind of healthful return on our investment.

Vane Lashua

Beacon, NY

I can't believe Americans can be happy with health insurance as it's available to the average person. If the "product" they were selling were a car, it would need a paint job, be missing a tire and emit smoke like a California brushfire. It would cost thousands of dollars and come with an owner's manual the size of a New York City phonebook that was completely indecipherable. Those who could afford a nice car would pass us by as we're sitting on the side of the road waiting for a tow truck that wasn't coming because the car broke down due to a pre-existing condition.

I don't need a limo or a Humvee, but at least give me something that runs reliably. Don't put forward a piece of crap and expect me to say, "Yes sir, she's a real beauty." If a government-run program can show me, say, a Taurus, I'll give the tires a kick.

David Durham

Chattanooga, TN

Tho far from perfect, one reform with no cost that would help many people is to allow associations and groups of employers to form purchasing groups by uniting in an industry group across several states.

This would help hundreds of thousands of people.

John D. Froelich

Upper Darby, PA