Friday, September 19, 2008

Help Me Understand This

A constant argument that I hear from those on the left who would pursue universal health care is the idea that we do not want an insurance company getting between a doctor and a patient.  As with most ideas that come from the left, this is one that sounds really great.

The problem is that those who are pushing this line of reasoning are the same people who are pushing for more coverage a la Medicare.  This does not add up.  As one who has worked in a private medical office and now in the ER, I can say without any hesitation (and I dare you to prove me wrong) that no reasonable, mainstream insurance anywhere (I'm excluding the fly-by-night outfitters here) has anywhere near the limitations that are found in Medicare, Medicaid, Tricare, and other government-sponsored insurances.

From my time in a private office, I came across way more prior authorizations than I would have liked to deal with, and many times became frustrated at insurance companies for second-guessing the decisions of doctors, but the red tape of insurance companies was like a walk in the park when compared to the difficulties of dealing with government-sponsored plans.  Most of the time an insurance company would give way when a doctor insisted on a treatment or a medication, whereas Medicare or Tricare would make you jump through many more hoops, be much more difficult to contact, require more conversations with more bureaucrats, and in the end bend considerably less than any other insurance plan I ever came across.  Now that I work in the ER, the only time I find insurance becoming an issue is when it is Medicare.  If a patient is going to be transferred to another facility, for instance, the HUC (I hate that term) always looks at the insurance information.  Why?  Because if it is Medicare, then we have two or three additional forms to fill out in the desperate hope that the government will pony up for the necessary treatments, and if exact qualifications are not met, then guess who you find standing, immobile, between the doctor and the patient?  That's right: Uncle Obama Sam.

So when we have conversations about improving health care in the United States, I'm all for it, because I know that there are many problems; but can we at least do away with this idea that it is the insurance companies that are the biggest culprits for standing in the way of getting needed treatments?

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