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this post was submitted on 16 May 2024
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A Boring Dystopia
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I don't know what the figure is today, but I learned a while ago that 25% of all healthcare spending in the US is on paperwork. And the US spends a LOT on healthcare.
This is why the Republicans were so against the goverment-payer option for Obamacare. Not "because socialism," but because about 30 percent of the cost of healthcare in the US is actually the result of the middlemen, i.e. the private insurance companies in control of the entire system and their bureaucratic clusterfucks specifically designed to extract as much money as possible from both the patient and provider. A single payer or government option would reduce or eliminate that.
30 percent.
The entire private insurance industry at this point is just a make-work operation to increase the cost and complexity of health care for the sole purpose of benefiting... the private insurance industry.
Hospital charges $30,039.38 for therapeutic foot brace
insurance has only agreed to accept $4,382.40 as a charge for therapeutic foot brace
hospital graciously charges only $7,930.38 for Ergonomic Footrapche (miscoded), but will cut a deal and only charge $1,293.39 for Foot Brace, non-therapeutic.
Doctor prescribes Froobthrag Ultramnuntixx
Patient doesn’t know what’s happening; is told to make their own decision.
Patient receives a foot wrap
Patient receives a bill for $17,383.29 for Threnmgrotminexx and a $30 copay for seeing a preferred provider.
Thank you!
There was a time when paperwork and such was defensible.
Now, if carriers had a lick of sense, they’d realize that forms are dirt cheap online; and that it’s drastically less expensive just to pay the claim vs fighting it.
They don’t, of course, because mergers and sole-source pharmacies for “scary” meds, but that’s neither here nor there.
Whole idea of PBMs is wrong, offensive, and has set back my care. Know who should manage my pharmacy benefits, my fucking doctor. Full stop.