Backwards nation

The U.S. of A. is a backwards nation when it comes to health care.   No, I am not referring to the fact the this country is the only industrialized nation without universal government-sponsored health care.  I’m talking about the way health care is handled at the most basic entry level.

Suppose you come into a hospital or clinic anywhere in this country seeking care — doesn’t matter whether you are coming in for a regularly scheduled physical with your primary care physician — or whether you show up broken and bleeding in the ER.  The same opening process takes place everywhere from sea to shining sea.

What is the first thing you get asked? Do they say: ” What care do you need today?” — absolutely not!  Or what about: ” How can we help you? “– not a chance!

The first question is usually — “Do you have health insurance?” followed by “May I see your insurance card so we can make a copy of it?”  The real question that is being asked is “Who’s going to pay for this?”

Not only does the person at the reception desk need answers about your own health insurance coverage but also needs to check out the possibility that the condition that brought you into a medical facility on a particular day will be paid by workers compensation (for on-the-job injuries) or maybe even an auto insurance policy.

After all this multi-layered exploration of the payment mechanisms, only then does attention turn to the real reason you came there in the first place — providing medical care.  Only then does the subject become your medical needs.  Only if one arrives unconscious via ambulance can one avoid this meticulous discussion of who will pay for the care that has yet to be provided.  In the latter case, one’s companion, if any, will be asked those questions.

The amount of effort directed at figuring out payment responsibility is just one example of overhead that drives up the cost of health care in this country.    Every hospital and clinic has at least one staff position (and often many, many more) devoted to obtaining insurance information upfront and sending out the appropriate billing statements (in the proper format for each insurance carrier).

This overhead does not help provide direct patient care.  It just gums up the works at the reception desk. Plus, it delays the time when a patient will actually be face to face with a medical professional receiving care.   It is just one tiny reason why the U.S. pays double the amount of money for health care as other industrialized nations but lags in health outcomes.

If  health care reform could help wring some of this overhead out of the system, it would be more efficient and costs would rise less precipitously.

Instead  of focusing a significant amount of time and money on payment mechanisms the emphasis should be on patient needs from  the first moment they cross the threshold of a medical facility.

That is why I think this is a backwards nation.  We spend too much time on the wrong things.  Patient needs should come first, not the requirements of big insurance companies.  In other industrialized countries there are no gatekeepers at the reception desk worried about payments — instead their emphasis is on connecting the patient with the medical professional who can help them.

Just one example of why we need health care reform in this country, especially with a robust public option — no co-ops, no triggers, no tricks to line the pockets of the big insurance companies.  Just health care, plain and simple, for every one.  That should be the American way.

Explore posts in the same categories: health care, health care reform


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