Thanks for the explanation and it does make sense, but it sounds overly complicated and elitist...and then toss in profits as another motivator.
I don’t recall if I already said it in this thread, but if somebody was going to start a new country today they wouldn’t model thier healthcare system off the US. In fact it would probably quickly be removed from the list of options.
Yeah, we’ll that’s the for profit healthcare system for you. Nothing is easy or straightforward.
It’s worth mentioning that if you’re not careful, you can actually lose money billing insurance- whether it be subpar reimbursement rates, not using optimal billing codes, etc. What you can accept widely depends on what the overhead costs are. And now practices have to hire billing specialists to deal with the complexities of insurance, which only makes things more expensive.
In fact most hospitals lose money on Medicare and Medicaid patients, often making up the difference with inflated costs to private insurance and using other profit centers. It’s a totally inefficient system.
Mental healthcare is the worst when it comes to reimbursement, which is why more and more providers are moving to private-pay and more and more programs do the same. That’s why the waiting list for psychiatrists is often months through insurance. Unfortunately the people who need the most care typically have the least resources and the access to a quality of care that’s overburdened, overwhelmingly understaffed, and underfunded.
One of the therapists that works for me used to have a caseload of 120+ patients with 40-50 sessions per week, working at a primarily Medicaid program. How good can even the best therapist possibly be if she has to keep track of 120 clients at once- and basically only enough room to see most clients 1x per month. At that point you’re really just pretending you have a relationship with the patient.
And don’t get me started about pharmaceutical coverage and the ridiculous, inadequate reimbursement system based on a game of smoke and mirrors and middlemen.
Switching to universal healthcare would definitely make things a lot easier, but I’m not sure how that could even occur at this point with a medical-insurance-pharma-biotech industry so tightly immeshed and financially dependent with each other.
If there’s one benefit to our healthcare system, the ridiculous amount of money that flows through it has enabled a tremendous amount of innovation that would otherwise be much more difficult to fund.
At the very least, there is a lot that could be done to reform the inefficient healthcare system we have. I don’t expect much change to happen unfortunately. Whatever changes politicians speak of either never happen, are designed to have no significant effect, and all too often mysteriously, end up benefiting the insurance and pharma industry.