Health "insurance" business model = FAIL
Defining "medical expense" in order to quantify "medical loss ratios" is the next level of "reform".
This is merely a game to maximize money insurance companies can hold onto. And the stakes are huge. 1.7% of administrative fees = $500 million. Think of all the real healthcare we could use that money for.
This is long tail stuff. The system is so magnificently bloated that even small percentages equal vast sums of money. Smells, to me, like a "bubble" similar to Wall Street.
Notice the game-players and rule-makers are insurers, legislators, and regulators but not physicians and patients. So, essentially, the people largely responsible for exploding healthcare costs are going to make new regulations to "protect the consumer". Don't think so.
Keep in mind, this banter will do NOTHING at the patient-doctor level except make it more difficult to spend time with, listen to, and develop professional, longitudinal relationships so that we front-line primary care physicians can authentically CARE FOR our patients.
http://amplify.com/u/5vu2
Knowing the Price of Everything and the Value of Nothing | John Goodman | NCPA
Check out the comments.
The Medical Quack: Can Algorithms Find the Best Intelligence Analysts? – Not Until Biases and Memory Lapses Are Overcome And That May Be A Long Time Coming And That Goes for Health Insurance Analytics Too - Bruce Hopper Jr MD empowered by HelloHealth
Algorithms. There is absolutely nothing HUMAN about them. They deconstruct healthcare to a commodity.
Advanced Primary Care’s VALUE is HUMAN RELATIONSHIPS. 3rd party payers will never reimburse doctors for the resources necessary to deliver on preserving this Patient-Doctor relationship.
There is simply no way to “measure” this value because it can only be “valued” subjectively by each individual patient.
If you are an individual who wants to PARTICIPATE in your health and COLLABORATE with a physician when you are sick, then good luck finding a doctor through your anonymous “insurance plan”.
If you are a physician who wants to deliver real CARE to your patients, then what are you thinking signing contracts with insurance companies who base payments on biased algorithms? “Reimbursements” that don’t cover overhead in addition to onerous, valueless administrative requirements to collect on these pathetically anemic payments.
Join me in restoring the professionalism to real primary care medicine.
