Chris Pope tries to make the argument that health insurers are the stewards of the health-care dollar, and that by saying “no,” insurers prevent unnecessary claims and waste because there is so much money to be made from the reimbursement of medical services (“Be Grateful for Your Health-Insurance Company,” op-ed, Sept. 12).
Reality check. It costs more to get authorization, bill, collect and keep up with regulation than it does to take care of the patient. When elderly patients are repeatedly denied home services that would keep them out of the hospital, it takes doctors and nurses significant time and resources to ensure the care continues. Whom do you trust more: an insurer who wants to reduce cost or the doctor who wants to reduce suffering?
The story of doctors overcharging is an old one and needs to be put to rest. We have a critical shortage of physicians, specialists in particular, with 48% burnout and over half employed or in debt. Despite amazing advances in technology that have dramatically reduced complications or recovery times, the insurers are still using outdated cost data from 30 years ago. They are standing in the way of progress.
The truth is, it is now cheaper to take care of the patient than to manage their care. We don’t need insurer data collectors and administrators to create obstacles, and, anyway, they have become too expensive. AI may be a better alternative. We need a transparent system that fits with the future of health care, not its past. It is not that hard to do.
Date: September 19, 2019
Source: WSJ