Insurance Profit - Yes There is Blame
Health Affairs had an analysis of why hospital bills are so high and said you could "Blame the Paperwork". Anyone in the health industry could have told you that! The amount of waste and expense in getting the bill paid by the insurance company could cover the uninsured in the U.S.
The study, funded by PNC Financial Services Group, contends that about one-third of all healthcare costs can be attributed to administration—an unacceptably high share, according to the 1,000 consumers who were surveyed along with 200 hospital and insurance company executives. Here is what they found:
- Hospital executives reported that one in five claims submitted is delayed or denied and 96 percent of all claims must be submitted more than once.
- Hospitals that do not use electronic billing or claims submission processes reported resubmitting a claim 11 times or more, or nearly four times more than those hospitals using electronic processes.
- Insurance executives surveyed say they go back to hospitals twice, on average, to get all the information needed to pay a claim.
- Nearly a quarter of consumers reported having had a legitimate claim denied by their health plan, and one in five ultimately paid the claim out of pocket.
Let me break this down into its simplest form. Insurance companies are for-profit, wall street conglomerates. There is no mystery why the largest buildings in any metropolitan city are insurers. They have posted record profits for years. They make their money by taking in more money than they spend on health care. Denial of claims, rules that no one understands, underwriting only healthy people and then dropping them when they get sick all means profit. If they can delay paying claims for several months, billions of dollars are the "float" that they keep. For smaller claims, like doctors bills, we just give up and eat it because we can't afford to keep submitting claims for $50.00. Patients give up too. Wall street loves the insurance industry... America loves them....Politicians love them.
Paula Fryland, executive VP of PNC's national health care group said: “I don’t think there’s anyone to blame, per se; it’s a reflection of the complexity of the payment relationship between insurers and hospitals. The benefit we have in our system of choice and customization is part of what makes things more expensive.”
Wake up, America! There is plenty of blame! This system of choice and customization provides little benefit at great cost. The major benefit goes to Wall Street. I love profitable companies also. I just don't want the profits to come from my health care dollar. I want that dollar to pay for health care...either mine or my fellow American.