Sunday, September 20, 2009
The Health Care problem in America
Here is what I know. I am a provider on many different insurance panels. A lot of my colleges are not. I know why they are not, they got tired of the constant fight with Health Insurance companies to get paid. They take private pay(CASH)only and certain EAP's(Employee Assistance Program) that are very easy to work with. These same Therapists are now seeing dramatic drops in their Private Practices because most of the public in these hard times cannot afford $120 an hour, even for Therapy. I do not want to embellish my ability, but I saw this coming. That is one reason I decided to get paneled on every insurance that I could.
My other reasoning for taking and keeping my standing in the Health Insurance quagmire is I believe that if people earn benefits they ought to be able to use them. I encourage people to use what they pay for if they need it. In this time of economic challenge, my Private Practice is full. This does not mean I am doing better than other Therapists, I am not. I spend a minimum of 60 -90 minutes a work day per week trying to extract payment from the Health Insurance industry. So, per hour if someone charges $100, and they take cash, they get $100 for their effort minus overhead. I charge $100, but Health Insurance companies will only pay $60(which I am willing to take for the sake of the client) minus overhead, but it is also minus $15 for the extra time I have to spend trying to get paid from the Health Care industry. So, I make $45 an hour minus my overhead. This is dramatically less than my colleges make per hour because of the Health Insurance industry.
This is the same industry which the naysayers to Public Sponsored insurance say does a better job than the Government. This is the same industry that pays their CEO's 7 and 8 figure incomes, 9 figure incomes if you include bonus and stock options. This is the same industry that is spending 1.8 million dollars a day on the Congress to stop a Public Option in any reform bill that comes from Congress. Gee they must be really scared.
Something else I know, Health Insurance company profits increased during 2002 to 2006 from 1.7 billion to 15.6 billion dollars.
This is the same percentage increase as the rise in Health Care costs. This happens while the same companies deny payment to me for silly reasons like, they cant read the date of birth, they do not have the name spelled correctly in their system, they did not record an authorization when they client called in to get the authorization(even though they have a record of the client calling), and sometimes they just do not pay until I have submitted the bill several times. I have gotten paid as long out as 8 months. This is ALL of the Health Care companies. Some EAP's are good to work with. Victim Witness(a government sponsored Health Payment program)is good to work with and pay full fee. This is what I know about the Health care industry.
It is time to have a real debate about Health Care in America. Everyone agrees that we need a change. If government sponsored Health Care is so bad, we will need to change Medicare and the Veterans Administration, because they are the largest government sponsored Health Care administrations in the world. I would prefer to have the government to work with, they would have one set of forms to fill out instead of 12 different forms. I would have only one set of benefits to bill for instead of the convoluted 4-5 sets of benefits for each company. The government does this kind of thing out of stupidity, insurance companies make this process confusing in order to make money. They do make a lot of money.