Monday, July 13, 2009

Reform Rx – The Bureaucrat Between

One big contention from those who would deny Americans of substantive health care reform for all is that it will “place a bureaucrat between you and your doctor who will make decisions about your health care for you”. The unspoken implication is that decision will be based on frugal formulas and denial of treatment by an uncaring robotic government bureaucrat like that found in some 1960’s socialist parody.

Surprise; there is already a full fledged faceless bureaucracy making those decisions for you within private for-profit health care! Definitions of a bureaucracy are not limited to governments but include “concentration of power in administrative bureaus or administrators” and “administration characterized by excessive red tape and routine.” Insurance companies are the very definition of a bureaucracy full of faceless bureaucrats.

Take a good look at who presently comes between you and your doctor. The private insurance bureaucrats review cases to deny care, relentlessly reduce the amount they need pay, and steer patients into less effective but more profitable care regimes. They use formulas to determine mortality ratios versus the legal risk of denying claims. They use special software to make their robotic decisions to catch obscure and unrelated technicalities that get them off the payment hook using pre-existing conditions allegations. They study and determine what small businesses ought to have their policies rescinded based on medical loss ratios to appease their investors not their customers. They have bureaucrats running around Wall Street to determine what kind of care is worthy of profitable investment rather than being even remotely based on pragmatic medical needs. Finally, they are not interested in your family doctor at all; the bureaucracy thrives on pre-packaged tests and specialist evaluations that can be debunked by corporate doctors or used for denial purposes.

And dealing with the bureaucratic insurance billing and administrative staff can be a nightmare for any average person. There is relentless arguing for coverage of vital procedures, the hassle of many bills from a multitude of unknown providers, and frustration upon frustration of transferred calls, waiting on hold, and unemotional detached claims denials.

Let’s pass health care reform to extract us from this insufferable bureaucracy!

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