Healthcare, the cost of administration

This is quite interesting…
http://worldfocus.org/blog/2009/01/28/how-the-us-measures-up-to-canadas-health-care-system/3783/#comments

What is the cost of administration in a US hospital…

To give a comparator, the hospitals in which I work have between 400 (at the small end) and 850 beds. The number of people involved in the coding and billing for these organisations range from 6 to 15+.

They are responsible for going through every discharge, attributing the correct procedure according to its HRG code (the code that determines what the procedure was and what gets billed) and ensuring the data is accurate so that it can be sent to the commissioners (insurers for the purposes of this scenario).

I’ve seen organisations that are up to 45 day behind and others that are coding on day of discharge, now the question is whats the cost of administering this level of activity in the US system. I’d guess they need more than 10-20 people.

I think someone needs to work on reducing the paperwork…

I’d like to make several points just from glancing over this.

First a bit of Irony;

** **Most Americans, first of all, are bombarded with propaganda. You don’t know how many think tanks are paid by certain industry — insurance, drug, organized medicine — to feed out negative stories about the Canadian health system

Here is a story saying how bad the US system is and also claiming we are bombarded with stories about how bad the Canadian system is. The last story I remember about “How bad” the Canadian system was the one where the person had to or chose to go to the US to give birth or something. Even that turned into a “how bad the US system was” because we charged Canada too much for our services. That was many many many months ago. OTOH I read on a near daily basis how bad the US system is.

**Uwe Reinhardt: **You’d be talking 800, 900 people, just for the billing, with that many hospitals and being an academic health center.

No ones arguing there isn’t billing issues in the US. What is being argued is that whether or not a GOOD deal of those billing issues are caused and influenced in part or entirely by government intervention.

I’ve stated several times that I was told by my aunt and uncle both have been involved at fairly high levels in the health care system that for every hour a doctor sees a patient 10 hours of paper work is generated. They also suggested that 70-80% of that paperwork was generated to fulfill some government mandated regulation, not to help with the patients healthcare or insurance directly.

Even the simple fact that we have 50 different Blue Cross & Blue shield companies instead of one is largely due to individual state law, not insurance company choice. Multiple that by however many insurance companies and you have a major Cluster F@!# before you even start.

and finally

  • Well, it works. We have a Canadian health plan in America. It’s called Medicare. It works. Don’t tell me medicare doesn’t work. Tell that to the elderly. One way to test it is to say “Let’s take it away.”*

I’ll tell him it doesn’t work, because it doesn’t. Although Medicare is far better than medicaid people are still stuck paying ridiculous amount for drugs on Medicare and many even most people end up buying “Supplemental” insurance for medicare. Medicaid, a similar program, for low income, is nearly an abject failure in the state of Illinois with doctors literally refusing to accept patience and payments running as much as 10-12 months behind.

I’ll use the same argument here that BarryP uses on “Private education”. When you’re only covering a small portion of the population and drawing resources from the entire population it’s pretty easy to say “Hey we made it work”, but try covering the entire population under a similar system as Medicare and coverage will be inadequte and prices with go thru the roof.

~Matt

And who created the nightmare of adminstration in the hospital? I know in the US, its was the govt, period. Its all one big game, dominated by the govt with private business trying to figure a way to make a profit while satisfying govt regulations…plus at least in the US, some of the healthcare systems are really behind on using technology to speed up and improve the processes around discharge, claims, payment, etc.

Medicare is a joke. Paying approximately $.16 on the dollar for billed charges? Anyone who actually thinks it “works” obviously has very limited knowledge (perhaps only in one geographic region and with university sponsored hospitals?) of the system here in the U.S.

Let’s remember WHY we have regulations…

Not every regulation is good. Just because it is called a regulation doesn’t mean it’s useful.