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I'm on the side of the insurance companies. they are likely the only "responsible adults" keeping providers in check. Providers are extremely wasteful and "cre

I'm on the side of the insurance companies. they are likely the only "responsible adults" keeping providers in check. Providers are extremely wasteful and "creative" with their billing. Staff are generally idle, and staff-to-patient ratios are 10-20:1 if not more. There is little urgency around the clinic, staff take off at 4pm and are impossible to catch on a Friday. Every procedure bills a redundant and pointless "consult"-- a $1500 meeting that could have been an email. Providers benefit from possibly the best PR of any industry. Insurance companies are the "Ticketmaster" of the healthcare industry. Their entire objective is to be the punching bag for wasteful healthcare providers.

sarchertech 1y ago
Most doctors don’t do their own billing. It’s too complex. They have specialists who take their notes and turn them into bills.
- tonymet 1y ago
  while you're right most of the billing pressure is likely coming from administrators and boards, doctors do participate with petty / pointless consults , excessive testing & procedures, absurd hour restrictions, and indirectly through medical boards reducing capacity, among other factors
  - sarchertech 1y ago
    >indirectly through medical boards reducing capacity My wife has served on government medical advisory boards, and handles resident education. I've heard plenty of virtual meetings in the background. I've never once heard anyone discussing adding requirements for any unnecessary reason whatsoever. Not even a hint anything that would reduce capacity. If anything it's "how can we add capacity without reducing quality?" >absurd hour restrictions What do you mean by hour restrictions? The only hour restrictions that are enforced are on Residents and that is 80 hours per week. If you're talking about doctors choosing to work less than 40 hours per week, that's general because they'll completely burn out. My wife is a pediatric ER doctor, she works less than 40 hours per week, but she has no set schedule and could be working 7a-4p one day, 1p-11p the next, and 10p-7a the next. For many of those shifts she's the only doctor there, and is responsible for the life and death of every single patient that walks through the door. She's the one who gets to tell a young mom that her 3 year old has a brain tumor, she's the one who has to code an already dead 5 year old found face down in a pool victim for an extra 15 minutes so her parents can get there because studies have shown it helps them process grief if they can see people doing everything they can to save their kid. And to top it off any mistake she makes could literally cost us our house because it's relatively common in our state for people to awarded judgements that are larger than malpractice insurance limits. If she worked 40 hours a week she'd be completely burned out in 6 months. >excessive testing & procedures You can 100% blame fear of litigation for that. My wife is constantly balancing her desire to save patient's parent's money with her desire to get answers and her fear of legal liability. >petty / pointless consults You can blame fear of litigation for that one too. Calling in a specialist for a consult works the same as testing. It's a balancing act. I know a lot of doctors, some of them are assholes, but I don't know a single one who even consider changing their treatment recommendations based on how much money it nets them.
    - tonymet 1y ago
      I'm sure there is a noble excuse for every one of these problems. But the providers have the most leverage in reducing costs, so they must also accept the blame. My complaint is two parts really. Providers are wasteful, and policy makers are not able to pressure them to optimize, because of the incredible PR. In other words, there's no hope to reverse healthcare insolvency because cost growth will continue to explode with this combination.
zaptheimpaler 1y ago
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danny_codes 1y ago
I mean aside from the fact that insurance in healthcare don’t provide any value at all, and healthcare providers provide, you know, actual healthcare, then sure. Healthcare insurance companies are completely pointless because healthcare is a human right. All other developed countries have figured this out and provide healthcare universally. We could fully socialize “healthcare insurance companies” and have exactly zero negative repercussions. The only outcome would be eliminating a useless industry and saving ~$500 billion a year.

sarchertech 1y ago

Most doctors don’t do their own billing. It’s too complex. They have specialists who take their notes and turn them into bills.

tonymet 1y ago
while you're right most of the billing pressure is likely coming from administrators and boards, doctors do participate with petty / pointless consults , excessive testing & procedures, absurd hour restrictions, and indirectly through medical boards reducing capacity, among other factors
- sarchertech 1y ago
  >indirectly through medical boards reducing capacity My wife has served on government medical advisory boards, and handles resident education. I've heard plenty of virtual meetings in the background. I've never once heard anyone discussing adding requirements for any unnecessary reason whatsoever. Not even a hint anything that would reduce capacity. If anything it's "how can we add capacity without reducing quality?" >absurd hour restrictions What do you mean by hour restrictions? The only hour restrictions that are enforced are on Residents and that is 80 hours per week. If you're talking about doctors choosing to work less than 40 hours per week, that's general because they'll completely burn out. My wife is a pediatric ER doctor, she works less than 40 hours per week, but she has no set schedule and could be working 7a-4p one day, 1p-11p the next, and 10p-7a the next. For many of those shifts she's the only doctor there, and is responsible for the life and death of every single patient that walks through the door. She's the one who gets to tell a young mom that her 3 year old has a brain tumor, she's the one who has to code an already dead 5 year old found face down in a pool victim for an extra 15 minutes so her parents can get there because studies have shown it helps them process grief if they can see people doing everything they can to save their kid. And to top it off any mistake she makes could literally cost us our house because it's relatively common in our state for people to awarded judgements that are larger than malpractice insurance limits. If she worked 40 hours a week she'd be completely burned out in 6 months. >excessive testing & procedures You can 100% blame fear of litigation for that. My wife is constantly balancing her desire to save patient's parent's money with her desire to get answers and her fear of legal liability. >petty / pointless consults You can blame fear of litigation for that one too. Calling in a specialist for a consult works the same as testing. It's a balancing act. I know a lot of doctors, some of them are assholes, but I don't know a single one who even consider changing their treatment recommendations based on how much money it nets them.
  - tonymet 1y ago
    I'm sure there is a noble excuse for every one of these problems. But the providers have the most leverage in reducing costs, so they must also accept the blame. My complaint is two parts really. Providers are wasteful, and policy makers are not able to pressure them to optimize, because of the incredible PR. In other words, there's no hope to reverse healthcare insolvency because cost growth will continue to explode with this combination.

zaptheimpaler 1y ago

[dead]

danny_codes 1y ago

I mean aside from the fact that insurance in healthcare don’t provide any value at all, and healthcare providers provide, you know, actual healthcare, then sure. Healthcare insurance companies are completely pointless because healthcare is a human right. All other developed countries have figured this out and provide healthcare universally. We could fully socialize “healthcare insurance companies” and have exactly zero negative repercussions. The only outcome would be eliminating a useless industry and saving ~$500 billion a year.