Wouldn't this time and money be better spent taking care of patients?

A recent study published in Health Affairs estimates that the cost of time spent by physicians and their office staffs interacting with insurance companies was $21-31 billion annually, or about $68,000 per physician per year. This includes nearly 4 hours of nursing staff time per physician per day, and 7.2 hours of clerical staff time per physician per day, as well as 43 minutes per day of direct physician time.

Wouldn't this time and money be better spent taking care of patients?

A thought to consider as we debate the future of healthcare delivery in this country.

Expanded healthcare coverage...at what cost?

The Obama administration's goals for expanding healthcare coverage to those who are currently uninsured is admirable, and who could criticize such a plan? Wouldn't we all like to have the security of knowing that our healthcare needs will be met, no matter what the future brings?

Much has been written about the direct costs of such a plan. The estimates are probably no more accurate than the estimates for GM's needs to avoid impending bankruptcy.

What about the indirect costs to our society in the form of future tax increases for funding the plan, and in the form of inflation created by growing deficits that will be passed on to our children and grandchildren?

How about the costs to our healthcare delivery system, that will be forced to accept lower payment rates for providing healthcare services. One cannot afford to deliver care that costs more than the reimbursement given for very long. Neither hospitals nor physicians can make up the loss generated on each transaction by increasing the volume of transactions.

Meanwhile, our patients demand better, more accurate diagnostics and cures, despite the costs involved in providing them. Our current healthcare delivery often removes the consumer (the patient) from the financing of the purchase, which is handled by anonymous insurers or government agencies. There is always unlimited demand for a "free" service, and patients feel they are entitled to unlimited care, despite their ability or inability to pay for it.

As we transition to increased public financing of this effort, how do adjust our patients' expectations that they can continue to use services without any limits? And if limits are imposed, will they simply access the system through healthcare's back door, the emergency room, where the threat of a plaintiff's attorney's shadow is always lurking if a bad outcome occurs?

We need more than the bandaid of a new entitlement program to solve the problems of healthcare financing and delivery. We need a frank discussion of what our society's goals and objectives should be. Only then can we design a system to take us there. As Lewis Carroll wrote: "If you don't know where you are going, any road will get you there." We have come to a fork in the road. We should follow Yogi Berra's advice, and take it.