Monday, August 29, 2011


The August 25 edition of the NYTimes Well Blog ( relates a study showing how much American doctors spend just trying to get compensated by insurance carriers.

The study, published in today's edition of Health Affairs ( estimates that while Ontario, Canada, physicians spend an annual average $22,205 interacting with Canada’s single-payer agency, their American counterparts spend $82,975. American physicians' office staffs spend  20.6 hours weekly interacting with health plans—nearly ten times that of their Ontario counterparts. If US physicians had administrative costs similar to those of Ontario physicians, the total savings would be approximately $27.6 billion per year. 

How to account for our persistence with such an obviously wasteful strategy? I don't believe we Americans are masochistic, just poorly informed. If we looked seriously at our own experiences in this system, we'd scream for reform.

For example, I recently saw my own doctor just to get a prescription refill. Ours is an older community, so most of his patients are on Medicare, which reluctantly but continually reduces physician payments. This leaves him earning less than some on his staff, so he's limited his participation in Medicare. That means that I needed to pay cash for my visit, assured that I'd somehow be reimbursed. Sure enough, a check arrived a few weeks later from somewhere in Georgia that paid me for half the visit. And a month after that, his office sent me a check paying most of the remainder, along with an explanatory letter. I wondered, then, how much it cost simply to reimburse me.

American healthcare's financial "system" is as complex as seventeenth-century Japanese imperial court manners--and even worse, it's riddled with unnecessary middle people who bleed it without adding value.

Again, I urge you to see the video "Health, Fear & Money" at, a gloriously clear explanation of our Gordian healthcare knot.

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