That is nonsensical. Medicare actually requires less paperwork and fewer challenges that private insurance. That is why the GAO cites it as “potentially high risk” for fraud.
Look at Ridgerunner’s comments. He knows that the private insurers fight tooth and nail to pay out as little as possible.
This has created a growing industry. For example, I have very good medical coverage, but I opt for what is now referred to as ‘concierge medicine’. Rather than see a doctor who crams in 40 office visits a day and then spends hours before and after battling with private insurers, I see a doctor whose entire patient base is less than 500. If I call with a question, I get him on the phone. If I need to see him, it is same day or next. If I have questions while I am there, he’ll sit down and talk to me for as long as it takes. But, of course, I pay for this. I still have my drug benefits and excellent PPO insurance for tests and hospital stuff.
This is, presumably, the GOP ideal. I can afford it, so I get better health care. But I find it troubling. The service I’m getting now is close to what I received as a child (minus the house visits), and I grew up on a home with no indoor plumbing. And it is not particularly special for many industrialized nations around the world. But even though we in the US are paying more for health care than anyone else, ‘good’ health care for many is now the HMO cattle call experience and 40 million or so Americans don’t have even that.
Indisputably there are some “cattle call” aspects to medicine, largely related to the income expectations of the medical giants, not the payment source. My wife directs medical care for ARC folks, virtually all of whom are on Medicaid. Those people get more and better care than her or me, by far. She makes sure of it.
A lot of it also depends on where a person lives, and the number of physicians in that area. A middle sized city near here is a “doctor magnet”. Those physicians to whom I have talked about it talk about the “quality of life” as being the motivating factor. Good place to raise a family for a lot of reasons. Perhaps as a consequence, there are lot of doctors per capita here as well, though this town is smaller. Fewer amenities, but the same basic living situation.
I never have any trouble getting doctors (surgeons excepted) on the phone, or at least getting them to return my call.
So, surgeons notwithstanding, I guess maybe we’re getting “concierge” medicine without having to pay the premium for it. This is an extremely Republican part of the country, and nearly every doctor I know is a Republican, so I don’t know that “cattle call care” is necessarily a “Republican ideal”.
A brother of mine, who lives in a large city and who actually has better coverage than I do, does get the “cattle call” treatment a lot. But that’s a medical organization thing, not an insurer thing. I guess some of those giant, very profitable, medical organizations it because they can get away with it.
Interestingly, his son in law, who practices medicine in that city, discussed with me his desire to be in a less stressful group than the one he was then with. He didn’t want quite such a patient load. During his “thinking period” I strongly encouraged him to “strike out” on his own with a handful of other doctors he knew who were thinking of doing the same thing. But he didn’t do it and stayed with the “cattle call” organization because he was nervous about the investment required, the drop in income he could reasonably expect starting up and the retirement plan in the big group. (He’s in his thirties) The other guys did go out on their own. Sometimes what happens in medicine is the same thing that sometimes happens in any other walk of life. The giant employers do provide security, or the appearance thereof, versus being “on one’s own”. For some doctors, as with many people in other walks of life, (my own occupation is no different) security is more highly valued than the degree of independence (and insecurity) they might have with fewer patients. But they pay a price for that additional degree of security.
Maybe the Republican doctors around here understand that a little better than some.
I will agree that good insurers do fight to keep costs down. But the big effort is getting the pricing agreements in the first place, not denying treatment. There’s no money in that, compared to obtaining pricing agreements, and there’s a lot of adverse publicity attendant on denying treatment. The government doesn’t have to worry about that, or doesn’t. I will say that insurers do spend considerable effort fighting abusive practices like unbundling, upcoding and “inadvertent” departures from the pricing agreement.
Indisputably, there are problems with healthcare in the U.S. Perhaps the biggest one of which I am aware is the government’s acceptance, authorship really, of “Reasonable and Necessary”, an outrageous pricing system which is neither “Reasonable” nor “Necessary”. That’s what you pay if you aren’t insured or indigent, but only because the government requires a “tiered” system. The whole silly thing also requires a lot of paperwork overhead.
I’ll add, just for the record, that I’m not a Republican. I just have a problem with claiming they’re responsible for every problem from the cost of medical care to lightning hazards on golf courses.
I love ironic humor! 