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Health Care

The current health care system in America has become increasingly unfair in terms of patient access and distribution of health care services. In terms of access, Americans with moderate incomes are being priced out of the health care system. This is a direct result of the health care insurance industry shifting cost as well as risk of illness and injury to citizens, health care providers and government at an accelerating pace.

While those fortunate enough to have health insurance struggle with escalating premiums, skyrocketing deductibles, and declining levels of coverage, the broadening cross-section of society that is the un-insured, has risen to record levels. Increasingly, employers, workers and families are choosing to go without health insurance coverage because they simply are unable to afford the premiums. While health insurance industry profits continue to reach new heights, the associated escalating financial and societal costs of caring for patients without health insurance shows no indication of abating,

Physicians and other health care providers bear much of this cost as they face an ingeniously engineered bureaucratic maze when attempting to seek reimbursement for covered services. The purposefully engineered bureaucracy that is the private health care financing system results in an excessive cost burden that has nothing to do with providing services, but has everything to do with maximizing profits.

The complexity of this system, which is inherently confusing and forever changing adds unnecessary administrative costs to the system. While these administrative costs are mostly born by the provider secondary to the processing of insurance claims as well as service claims denials, the total costs of untreated illness and lost productivity are born by the American citizen.

The private health insurance industry composed of multiple corporate entities each with their own peculiar set of patient coverage and provider reimbursement rules, forms and regulations, is the means by which the insurer decreases it's risk at the expense of the service providers, as well as the insured. Multiple sets of rules and restrictions resulting from multiple insurance providers causes confusion… resulting in errors in claims processing… causing denials resulting in lost claims/reimbursement for service providers, and increased bottom line profits for insurers.

Lost in the financial crisis, is the fact that the health care insurer often is in control of the care that the physician/health care provider is able to provide. Such losses in physician autonomy do not often benefit the patient and is a form of health care rationing, again with the express purpose of maximizing profits for the insurer. How can America deal with this growing crisis?