http://pnhp.org/blog/2008/07/14/uwe-reinhardt-on-the-dutch-system/ PNHP's official blog Wed, 10 Mar 2010 01:04:31 +0000 http://wordpress.org/?v=2.9.2 hourly 1 http://pnhp.org/blog/2008/07/14/uwe-reinhardt-on-the-dutch-system/comment-page-1/#comment-53 Jeoffry B. Gordon, MD, MPH Tue, 15 Jul 2008 10:20:17 +0000 http://www.pnhp.org/blog/?p=25#comment-53 As a solo practicing family doc I spend about 5% of my time and my staff spends 10 to 20 % of their time exploring and untangling multiple insurance company snarls (many within a well structured HMO system) which interfere with the appropriate and adequate provision of care. Examples: Just today we had to take care of two patients with corneal abrasions who had difficulty getting to see an ophthamologist due to insurance company rules and we have spent the last week trying to bring a patient who had a laceration of his orbit into his HMO system for care. Just consider how much time is lost from clinical services and is spent on this kind of wasteful bureaucracy. Another time consuming problem is that each insurance company has its own formulary (and I strongly believe in formularies) causing huge amounts of time to be spent working the system to get the right equivalent medicine that I already prescribed paid for. This is not to mention the 25 per cent of my office overhead that is spent dealing with multiple insurance payors. The American health system maximizes insurance company profit; is a full employment system for health bureaucrats; and is hugely inefficient. As a solo practicing family doc I spend about 5% of my time and my staff spends 10 to 20 % of their time exploring and untangling multiple insurance company snarls (many within a well structured HMO system) which interfere with the appropriate and adequate provision of care. Examples: Just today we had to take care of two patients with corneal abrasions who had difficulty getting to see an ophthamologist due to insurance company rules and we have spent the last week trying to bring a patient who had a laceration of his orbit into his HMO system for care. Just consider how much time is lost from clinical services and is spent on this kind of wasteful bureaucracy. Another time consuming problem is that each insurance company has its own formulary (and I strongly believe in formularies) causing huge amounts of time to be spent working the system to get the right equivalent medicine that I already prescribed paid for. This is not to mention the 25 per cent of my office overhead that is spent dealing with multiple insurance payors. The American health system maximizes insurance company profit; is a full employment system for health bureaucrats; and is hugely inefficient.

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