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A significant fraction of healthcare administrators are there to deal with insurers, both to negotiate pre-approval and then to get paid afterward. That's what

A significant fraction of healthcare administrators are there to deal with insurers, both to negotiate pre-approval and then to get paid afterward. That's what happens when you have thousands of insurance companies, each negotiating their own individual prices for everything. On top of that, you have to deal with insurers that will deny pre-approvals for medically necessary treatments on first request as a matter of course, then deny the first claim afterwards despite acquiescing to the pre-approval. And finally, patients may have primary, secondary, tertiary, and even quaternary insurers to ensure they're fully covered, so you have to figure out which fraction of the procedure each will pay. Rather than doctors spending their entire days haggling with insurers, they've hired administrators to offload the work so they can get back to being doctors. Unfortunately, the byzantine structure which is privatized health insurance has only continued to grow in size and complexity, necessitating a growing number of administrators to handle the interface between the two.

ETH_start 2y ago
The current share of healthcare spending that occurs through government and private insurers is due to government intervention. Out of pocket spending constituted the vast majority of spending in the 1950s before these government interventions were enacted. In contrast, cosmetic and laser eye surgery have mostly escaped the effects of these interventions, and are consequently the only fields of medicine where 1. most spending is out of pocket, and 2. prices have increased at below the rate of inflation. As for the socialized health care panacea, if you look at the health care systems of other countries where they have fully socialized expenses, you see huge problems, not exactly the same as the U.S.'s, but absolute disasters nonetheless. Health care as a centralized institution doesn't work.
Gibbon1 2y ago
A point, part of the reason insurance companies deny claims isn't because they think they can get out of paying. It's because doctors don't get paid for dealing with insurance. So they tie doctors up so doctors can't see more patients and generate billing.

ETH_start 2y ago

The current share of healthcare spending that occurs through government and private insurers is due to government intervention. Out of pocket spending constituted the vast majority of spending in the 1950s before these government interventions were enacted. In contrast, cosmetic and laser eye surgery have mostly escaped the effects of these interventions, and are consequently the only fields of medicine where 1. most spending is out of pocket, and 2. prices have increased at below the rate of inflation. As for the socialized health care panacea, if you look at the health care systems of other countries where they have fully socialized expenses, you see huge problems, not exactly the same as the U.S.'s, but absolute disasters nonetheless. Health care as a centralized institution doesn't work.

Gibbon1 2y ago

A point, part of the reason insurance companies deny claims isn't because they think they can get out of paying. It's because doctors don't get paid for dealing with insurance. So they tie doctors up so doctors can't see more patients and generate billing.