great interview on health care

[Azazello1313]

 

'It's a little bit like talking to a young prince," says Jonathan Bush, chairman and CEO of Athenahealth, a major player in information technology services for physicians, of his recent visits to Capitol Hill. "'So—tell me about this market thing that your people use,'" he says, mimicking the political royalty with a grin and extending his forearm. "'Wait: I must catch my falcon!'"

 

Athenahealth's headquarters, on the banks of the Charles River outside Boston, is a world away from D.C., and it's clear, as he continues his metaphor, that Mr. Bush enjoys the distance: "And these princes, they mean well and they're lovely," he says, "but they're living in this alternate universe where there's no such thing as a market in health care and they don't understand why one might be remotely useful."

 

He pauses. "That's weird to me."

 

Mr. Bush is an outlier in the generally buttoned-down world of the health industry. He's exuberant, hyperactive, speaking in frenetic running monologues; it's not hard to see why the political class might be taken aback: "I still have to keep going to Washington and sucking up," he says, switching metaphors. "Because the problem is when you have a baby with an Uzi, right, they might accidentally mow you down. But here's the thing . . . they're brilliant people. It's just that the idea of a market in health care never occurred to them."

 

As Mr. Bush sees it, the profound problem with U.S. health care is that there's "no landscape of choices, or choosers." Due to the complexity of America's third-party laundromat for health dollars—your doctor's clerical staff bills your treatment to an insurance company picked by your employer, and it pays him with your money via premiums or foregone wages—"few doctors in America know the actual value of the services they render."

 

Athena's core business helps them manage their practices and get paid, but the larger purpose of the company, which he and board member Todd Park co-founded in 1997, is to try to shore up health care's resemblance to a normal market. It has grown into one of the country's most innovative health IT firms.

 

Athena began as a San Diego birthing clinic and floundered because it couldn't cope with back-office volatility. All transactions were conducted on paper. No one understood how to navigate the dense and bewildering coding rules for dozens of different insurers or the fee schedules for government payers like Medicaid. Claims were denied with no explanation or vaporized in purgatory. The clinic went bankrupt in 18 months.

 

With Mr. Park (who has joined the Obama administration), Athena designed a program to digitize records and automate billing. It now colonizes the wilderness of paperwork and habitual financial chaos that defines running a doctors office, and it is also moving into clinical record-keeping for individual patients. Some 15,000 physicians in 43 states use Athena as a virtual office, a number that is growing at an annual 30% clip.

 

It is a massive logistical undertaking. Athena's main facility is housed in a decommissioned World War II arsenal on the Charles, where 30,000 pounds of paper is processed every month, most of the tonnage being paper checks. Incredibly, doctors also receive on average 1,185 faxes each month—mostly lab results—and those are handled too.

 

State Medicaid programs, by the way, are easily the worst payers, according to Athena's annual ranking. In New York, for instance, claims must be tendered on a dead-tree form instead of electronically and in blue ink—black is grounds for rejection—and then go on to spend a full 161 days, or almost a half year, in accounts receivable.

 

While streamlining this disorder frees up time for the company's clients to treat patients, it also throws off vast data, which are fed in central servers, aggregated and analyzed. This "athenanet" system is among the few health-tech offerings based on "cloud computing"—in the sense that the applications are accessed on the Web, instead of a computer's hard drive, allowing constant updates and refinements. If a regulation changes or an insurer adjusts a payment policy, it is reflected on athenanet almost in real time; on the clinical side, the program can adapt at the same rapid pace as medicine itself.

 

Mr. Bush thinks the main benefit is the "collective intelligence" that he is starting to weave together from the 87% of American physicians who practice solo or in groups of five doctors or fewer. "We found one of the last few remaining crowds in health care, which are these independent practices. Now you can argue that this decentralization is not the best thing in the world," but what's most important, he argues, is that "they're still allowed to go and make their own decisions."

 

In effect, as the network gets bigger, it gets smarter, while opening the space for innovations to feed off one another and spread. There really can be "radical improvement" in health care, Mr. Bush says, but only if there are "radical improvers" able to set themselves apart and lead the forward advance. "No one ever says, 'Here's to the average,'" he declares pointedly.

 

The Athena model is superior to most electronic medical record systems, or EMRs, which are generally based on static software that are inflexible, can't link to other systems, and are sold by large corporate vendors like General Electric. One reason the digital revolution has so far passed over the health sector is sheer bad product. The adoption of EMR in health systems across the country has been dogged by cumbersome interfaces, error propagation and other drawbacks. In 2003, for instance, Cedars-Sinai in Los Angeles dumped a $34 million proprietary system after doctors staged a revolt.

 

Athena also stands in marked contrast to most of the wider health-care market, which Mr. Bush argues is homogenized and rigid, and getting more so. The problem is "easily fixed by releasing some power into the arms of consumers and cutting employers and certainly the government out of it," he says, turning to ObamaCare. "Certainly I'm not commenting on the amount of wealth redistribution that we should do as a society. Fundamentally I believe we need some, and whether the amount we're doing today is enough or too much or not enough, that's not my thing. If we feel like rich people should pay more for not-rich people's health insurance, that's fine.

 

"But just give them the money," he cries. "It's totally inefficient wealth redistribution because they can't get creative with it. They're not allowed by law to get creative with it."

 

What Mr. Bush means is that the government imposes standardized rules and mandates with no concern for how much they will cost or who will bear the burden. Given the choice, consumers might decide on cheaper policies that cover some services but not others, or decide to run more risk.

 

Yet for all the talk about expanding coverage, Mr. Bush says the real problem is that "You can't buy what you want." Another way of putting it is that "America will have one car. Everyone will have access to transportation, which means that everyone will have a black Escalade, with spinners. That's it. There's no Hyundais, no bicycles, no nothing."

 

And it's scandalously unfair. "These poor people who clip the things off the backs of cans to make the tomatoes cheaper are subsidizing the hypochondriac who gets his shoulder done with an arthroscope because it clicks when he serves at tennis."

 

Under ObamaCare, Mr. Bush says, "everyone is going to get health care according to the wise-men benefit panel, who will tell you exactly what it is, and then they'll run out of money, so every year the wise panel will just squish the benefit a little. People will start to say, well, that's not going to work for me." For this reason he doesn't think central health planning will have any longevity, and eventually people "will start leaking out into the [private] market once we run out of Obama energy."

 

His company, he thinks, will play an important role in such a world, where individuals would have more responsibility for weighing trade-offs—which, he believes, is the only lasting way to enforce discipline in health spending: "Today it's so complicated that the average consumer—and this is what the academics say—you can't put the average consumer in charge, it's too complicated. Yeah it's too complicated! So let's make it not complicated," he says. Athenanet generates "clean information," the basic price signals about health care that "a regular old consumer could look at and say, 'That's worth it' or 'I'd rather do this one on the other side of Route 128 that does it cheaper.'"

 

Mr. Bush is less sanguine about the White House cost-control approach of better living through technocracy and "Benthemite micromanagement." As an illustration he singles out the idea of dispensing bonus payments to hospitals that find ways to reduce Medicare spending. If the bonus is higher than what the hospital would have been paid under the status quo, then Medicare is worse off—but if the bonus is less than what the hospital would have earned otherwise, in what sense is it an incentive to change? In other words, "I'm going to give you a dollar bill for every 10-dollar bill you give me?" Mr. Bush asks incredulously.

 

The irony is that Athena will likely benefit from the Project Mayhem that is about to begin. "It's probably terrible that all this new bureaucracy is being created," Mr. Bush says. "But there's going to be 50 new Medicaid-type plans in these insurance exchanges, run by the same insurance commissioners, these same sort of glazed-over-looking state secretaries of health. You know, just not really the brightest bulbs in the chandeliers of the world. Medicaid, the worst payer in the country by a factor of four! Mother of pearl! So I feel a little bit like a robber baron. I am going to make oil money dealing with them."

 

The double irony is that Athena—while Mr. Bush might not put it in such an impolitic way, but then again, maybe he would—is also showing that the status quo for all its flaws is capable of organic change and real progress without the blunt-force trauma Congress is likely to inflict. Or in spite of it.

 

Take the nearly $47 billion in stimulus cash the White House has budgeted to prime the pump for health IT adoption. Mr. Bush says he's glad his industry is getting more attention from the bully pulpit, but that "It is kind of too bad that all these software companies that we're really close to putting out of business, these terrible legacy companies, with code that was written in the '70s, are going to get life support. That's why I call it the Sunny von Bülow bill. What it is, basically, is a federally sponsored sale on old-fashioned software."

 

"It's designed like a box-buying campaign," he continues. "You get this fixed chunk of money for a few years, you get to pay off your EMR, like its a thing. People in Washington think in terms of things that we'll buy and then they'll be there. Buildings. Roads. Tanks. What Lockheed Martin makes. Things.

 

"And this isn't that. This is a market: its a set of agreements, it's a language. What's needed is a way of exchanging value and making choices, that's ethical—and, you know, nobody, nobody, not nobody, has said a word about that.

[BeeR]

What Mr. Bush means is that the government imposes standardized rules and mandates with no concern for how much they will cost or who will bear the burden.

...but with the "corporate" mentality, that's ALL they care about. Re medical care, both extremes blow. Badly. We need to find that happy medium somehow IMO.

 

Also incompetence and/or "shenanigans" are IMO severe beyond belief and must be dealt with - severely. eg hospitals/etc overcharging, charging twice, both they and insurance companies screwing up what's billed and how, ad nauseum. Having spent a lot of time w/people facing serious health issues lately I've seen a LOT of this and it's absolutely mind-blowing.

[Jimmy Neutron]

Good read.

[westvirginia]

This will go nowhere fast. In one of the obamessiah's books he referred to working in the private sector as "behind enemy lines". An admitted socialist sympathizer (it's in his books) who cannot recognize that free markets and private property rights are responsible for the innovation that's created our standard of living today? Not bloody likely.

[The Irish Doggy]

A lot of that sounds good and all, but I'd like to hear Mr Bush tell us why the current market managed health care costs continue to rise well beyond the rate of inflation. A market should be keeping costs down, but this one is not. He likes to talk a big game about innovation, making health care simpler, giving options, and maybe his company is going that, but then Mr. cloud computing appears to be the exception rather than the rule.

[westvirginia]

A lot of that sounds good and all, but I'd like to hear Mr Bush tell us why the current market managed health care costs continue to rise well beyond the rate of inflation. A market should be keeping costs down, but this one is not. He likes to talk a big game about innovation, making health care simpler, giving options, and maybe his company is going that, but then Mr. cloud computing appears to be the exception rather than the rule.

 

Maybe you missed this part:

As Mr. Bush sees it, the profound problem with U.S. health care is that there's "no landscape of choices, or choosers." Due to the complexity of America's third-party laundromat for health dollars—your doctor's clerical staff bills your treatment to an insurance company picked by your employer, and it pays him with your money via premiums or foregone wages—"few doctors in America know the actual value of the services they render."

 

And this

The problem is "easily fixed by releasing some power into the arms of consumers and cutting employers and certainly the government out of it," he says, turning to ObamaCare. "Certainly I'm not commenting on the amount of wealth redistribution that we should do as a society. Fundamentally I believe we need some, and whether the amount we're doing today is enough or too much or not enough, that's not my thing. If we feel like rich people should pay more for not-rich people's health insurance, that's fine.

 

[evil_gop_liars]

but then Mr. cloud computing appears to be the exception rather than the rule.

 

A Harvard Medical School study that looked at some of the nation's "most wired" hospital facilities found that computerization of those facilities hasn't saved them any money or improved administrative efficiency.

[bpwallace49]

As Mr. Bush sees it, the profound problem with U.S. health care is that there's "no landscape of choices, or choosers." Due to the complexity of America's third-party laundromat for health dollars—your doctor's clerical staff bills your treatment to an insurance company picked by your employer, and it pays him with your money via premiums or foregone wages—"few doctors in America know the actual value of the services they render."

 

Soooo according to Mr. Bush, the problem seems to be govt . . . and NOT insurance companies huh? So when an insurance company determines what doctor I can go to and what each procedure costs . . somehow that is the gubments fault?

 

Some good points are made in this article, but then to completely omit insurance companies and their role in this fiasco is disingenuous at best. I also really love when acticles refer to "Obamacare". It is comparable to everyone started calling the Iraqi War "Bush vs Iraq part II".

[bushwacked]

This will go nowhere fast. In one of the obamessiah's books he referred to working in the private sector as "behind enemy lines". An admitted socialist sympathizer (it's in his books) who cannot recognize that free markets and private property rights are responsible for the innovation that's created our standard of living today? Not bloody likely.

 

Have to agree here!

[westvirginia]

Have to agree here!

 

As usual, your contribution of meaningful, relevant insight is awe-inspiring. I'm sure MENSA is beating a path to your door.

[bushwacked]

The only worse thing than an admitted socialist is is an admitted foreigner socialist who implements death panels, double Have to agree here!

Edited December 16, 2009 by bushwacked

[Ursa Majoris]

Soooo according to Mr. Bush, the problem seems to be govt . . . and NOT insurance companies huh? So when an insurance company determines what doctor I can go to and what each procedure costs . . somehow that is the gubments fault?

 

Some good points are made in this article, but then to completely omit insurance companies and their role in this fiasco is disingenuous at best. I also really love when acticles refer to "Obamacare". It is comparable to everyone started calling the Iraqi War "Bush vs Iraq part II".

I have yet to hear any worthwhile responses to my questions on why a mammoth insurance bureaucracy that routinely denies health care requests and is buried under a mountain of paperwork is somehow intrinsically better than a government bureaucracy.

[gbpfan1231]

Have to agree here!

Very annoying. At least Ursa and BP off some decent input. Your replies are a huge waste of time.

[Pope Flick]

As usual, your contribution of meaningful, relevant insight is awe-inspiring. I'm sure MENSA is beating a path to your door.

 

 

Here's the quote in its context, which you clearly Have to agree here'ed:

 

… And so, in the months leading up to graduation, I wrote to every civil rights organization I could think of, to any black elected official in the country with a progressive agenda, to neighborhood councils and tenant rights groups. When no one wrote back, I wasn’t discouraged. I decided to find more conventional work for a year, to pay off my student loans and maybe even save a little bit. I would need the money later, I told myself. Organizers didn’t make any money; their poverty was proof of their integrity.

 

Eventually a consulting house to multinational corporations agreed to hire me as a research assistant. Like a spy behind enemy lines, I arrived every day at my mid-Manhattan office and sat at my computer terminal, checking the Reuters machine that blinked bright emerald messages from across the globe. As far as I could tell I was the only black man in the company, a source of shame for me but a source of considerable pride for the company’s secretarial pool. They treated me like a son, those black ladies; they told me how they expected me to run the company one day…

 

Nevertheless, as the months passed, I felt the idea of becoming an organizer slipping away from me. The company promoted me to the position of financial writer. I had my own office, my own secretary, money in the bank. Sometimes, coming out of an interview with Japanese financiers or German bond traders, I would catch my reflection in the elevator doors-see myself in a suit and tie, a briefcase in my hand-and for a split second I would imagine myself as a captain of industry, barking out orders, closing the deal, before I remembered who it was that I had told myself I wanted to be and felt pangs of guilt for my lack of resolve.

 

Then one day, as I sat down at my computer to write an article on interest-rate swaps, something unexpected happened. Auma called. I had never met this half sister; we had written only intermittently…

 

 

 

So he found himself on one career path, while basically pining for another. Yes, that's a clear indication of socialism! Have to agree here!!!11

[bushwacked]

Yes, that's a clear indication of socialism! Have to agree here!!!11

 

Have to agree here!

[wirehairman]

I have yet to hear any worthwhile responses to my questions on why a mammoth insurance bureaucracy that routinely denies health care requests and is buried under a mountain of paperwork is somehow intrinsically better than a government bureaucracy.

 

I will do my best to answer your question directly. From the article:

 

As Mr. Bush sees it, the profound problem with U.S. health care is that there's "no landscape of choices, or choosers." Due to the complexity of America's third-party laundromat for health dollars—your doctor's clerical staff bills your treatment to an insurance company picked by your employer, and it pays him with your money via premiums or foregone wages—"few doctors in America know the actual value of the services they render."

 

It would appear Mr. Bush does not believ private insurance is perfect and supports a freerer market for insurance as well as health care. The article also quotes him as saying:

 

State Medicaid programs, by the way, are easily the worst payers, according to Athena's annual ranking. In New York, for instance, claims must be tendered on a dead-tree form instead of electronically and in blue ink—black is grounds for rejection—and then go on to spend a full 161 days, or almost a half year, in accounts receivable.

 

The irony is that Athena will likely benefit from the Project Mayhem that is about to begin. "It's probably terrible that all this new bureaucracy is being created," Mr. Bush says. "But there's going to be 50 new Medicaid-type plans in these insurance exchanges, run by the same insurance commissioners, these same sort of glazed-over-looking state secretaries of health. You know, just not really the brightest bulbs in the chandeliers of the world. Medicaid, the worst payer in the country by a factor of four! Mother of pearl! So I feel a little bit like a robber baron. I am going to make oil money dealing with them."

 

I can only assume his statements regarding the poor performance of Medicaid is in comparison to private insurance, which would explaing "why a mammoth insurance bureaucracy that routinely denies health care requests and is buried under a mountain of paperwork is somehow intrinsically better than a government bureaucracy."

_________________________________________________________________

 

All that aside, the most alarming part of the article to me is that the government funding is going to bail out failing companies with health IT systems that have proven to be inefficient and ineffective. This can only stunt the growth of truly innovative companies, such as Mr. Bush's, that are actually improving health care services and providing "clean information" to health care providers and consumers alike. One of my biggest complaints about health care for a long time is the fact that very few people actually know the outrageous cost of health services and are only concerned about their deductable and/or co-pay.

[bpwallace49]

The funny thing is . . . if your employer does not provide health coverage, you have to go out IN THE FREE MARKET and get your own damn insurance. Which BTW is very expensive and most coverage is average at best. You are by no means REQUIRED to get insurance through your employer. That is just false.

 

Now if you are talking about STATE regulations that limit certain insurance carriers per individual state and allowing nationwide portability . . .I am prettttty sure that is a key talking point in overhauling the system.

[Jimmy Neutron]

I have yet to hear any worthwhile responses to my questions on why a mammoth insurance bureaucracy that routinely denies health care requests and is buried under a mountain of paperwork is somehow intrinsically better than a government bureaucracy.

 

I think it's a matter of degrees. The health insurance industry can be difficult to deal with. We've had claims denied and had to go back and forth with them - even had to threaten with letters from legal offices, but we've always won out. It's like making sure you get the right pricing at the market register. Caveat emptor.

 

I doubt I'd be as lucky with the government. There's a reason "governmnent" and "bureaucracy" go hand in hand.

[wirehairman]

The funny thing is . . . if your employer does not provide health coverage, you have to go out IN THE FREE MARKET and get your own damn insurance. Which BTW is very expensive and most coverage is average at best. You are by no means REQUIRED to get insurance through your employer. That is just false.

 

Now if you are talking about STATE regulations that limit certain insurance carriers per individual state and allowing nationwide portability . . .I am prettttty sure that is a key talking point in overhauling the system.

 

I did not state that anyone is "required" to get insurance through their employer. However, I suspect very few individuals turn down insurance through their employer due to group rates and/or contributions by the employer.

 

The majority of people I know only care what their deductable and/or co-pay is and never even ask how much a procedure, check up, etc. costs or if there is a more cost effective alternative. This would change if people were required to start paying for routine visits to health care providers and only carried insurance for catastrophic events.

 

Everyone is required to maintain car insurance on their vehicle in some form or other. As a hypothetical, what if car insurance suddenly covered routine maintenance of vehicles in additions to liability and collision damage? If a person had to fork out a $10 dollar co-pay for every oil change regardless of the cost of the service and lube shops realizing a potential gold mine doubled or trippled the cost for an oil change overnight, do you think people would (1) complain about the sudden cost increase in the service on a bill that goes directly to their insurance or (2) continue getting their oil changed at the same shop with their $10 co-pay and complain about increasing insurance costs?

Edited December 16, 2009 by wirehairman

[westvirginia]

I did not state that anyone is "required" to get insurance through their employer. However, I suspect very few individuals turn down insurance through their employer due to group rates and/or contributions by the employer.

 

The majority of people I know only care what their deductable and/or co-pay is and never even ask how much a procedure, check up, etc. costs or if there is a more cost effective alternative. This would change if people were required to start paying for routine visits to health care providers and only carried insurance for catastrophic events.

 

Everyone is required to maintain car insurance on their vehicle in some form or other. As a hypothetical, what if car insurance suddenly covered routine maintenance of vehicles in additions to liability and collision damage? If a person had to fork out a $10 dollar co-pay for every oil change regardless of the cost of the service and lube shops realizing a potential gold mine doubled or trippled the cost for an oil change overnight, do you think people would (1) complain about the sudden cost increase in the service on a bill that goes directly to their insurance or (2) continue getting their oil changed at the same shop with their $10 co-pay and complain about increasing insurance costs?

 

Very well put. If individuals got the same tax deduction for healthcare that employers do, it would effectively sever that link between employer and insurance companies. It would also put MUCHO competitive pressure on the insurance market, because consumers would see and feel the cost of everything. People would have more choices with plans including 80/20 splits, deductibles, etc, which creates an incentive for them to care about cost, instead of just letting the insurance co worry about it.

[bpwallace49]

Very well put. If individuals got the same tax deduction for healthcare that employers do, it would effectively sever that link between employer and insurance companies. It would also put MUCHO competitive pressure on the insurance market, because consumers would see and feel the cost of everything. People would have more choices with plans including 80/20 splits, deductibles, etc, which creates an incentive for them to care about cost, instead of just letting the insurance co worry about it.

 

I work for a company that is a 501 c (7) tax exempt company. We do not get deductions, cause we dont have taxes to pay on certain items that would necessitate deductions.

 

Our health care plan we provide (albeit for a small group of around 35 full time employees) is going up 54% next year, which works out to around 53K more in premiums paid by the company. This does not take into consideration the increase that the employees will have to pay on their part of the contribution, essentially giving them a pay cut for next year.

 

We have started pricing out individual health plans for employees and HSA's that the company would just pay the current contribution toward, that can be used for premiums or procedures. The difficulty we are having is that NO ONE has a real idea of what each procedure "should"cost, and insurance companies have an added advantage of their "negoiated" lower rates when you are part of a larger pool. Those same advantages do not necessarily extend to the individual purchaser that is not part of an employer group.

 

No matter what, in the end the people that need health care are screwed . . either by the insurance companies, the medical industry, or the gubmnet. Take your pick . . .

 

Anyone else know of an industry that raises prices by double digit percentages every year without any substantial increase in quality or efficiency?

[bpwallace49]

I did not state that anyone is "required" to get insurance through their employer. However, I suspect very few individuals turn down insurance through their employer due to group rates and/or contributions by the employer.

 

The majority of people I know only care what their deductable and/or co-pay is and never even ask how much a procedure, check up, etc. costs or if there is a more cost effective alternative. This would change if people were required to start paying for routine visits to health care providers and only carried insurance for catastrophic events.

 

Everyone is required to maintain car insurance on their vehicle in some form or other. As a hypothetical, what if car insurance suddenly covered routine maintenance of vehicles in additions to liability and collision damage? If a person had to fork out a $10 dollar co-pay for every oil change regardless of the cost of the service and lube shops realizing a potential gold mine doubled or trippled the cost for an oil change overnight, do you think people would (1) complain about the sudden cost increase in the service on a bill that goes directly to their insurance or (2) continue getting their oil changed at the same shop with their $10 co-pay and complain about increasing insurance costs?

 

Very well said. I also severely doubt that any of the health providers actually know/figure out how much the procedures they perform actually costs. In auto repair, you KNOW how much the part costs, and how much you charge for labor. Hell, it is on your bill! All too often, there is NOT transparancy on hospital or doctors bills, and their polices are/can be to NOT provide details.

[wirehairman]

We have started pricing out individual health plans for employees and HSA's that the company would just pay the current contribution toward, that can be used for premiums or procedures. The difficulty we are having is that NO ONE has a real idea of what each procedure "should"cost, and insurance companies have an added advantage of their "negoiated" lower rates when you are part of a larger pool. Those same advantages do not necessarily extend to the individual purchaser that is not part of an employer group.

 

Very well said. I also severely doubt that any of the health providers actually know/figure out how much the procedures they perform actually costs. In auto repair, you KNOW how much the part costs, and how much you charge for labor. Hell, it is on your bill! All too often, there is NOT transparancy on hospital or doctors bills, and their polices are/can be to NOT provide details.

 

It would appear that Mr. Bush from the article Az linked completely agrees with you and has started a very innovative IT company to correct the situation. From the article:

 

As Mr. Bush sees it, the profound problem with U.S. health care is that there's "no landscape of choices, or choosers." Due to the complexity of America's third-party laundromat for health dollars—your doctor's clerical staff bills your treatment to an insurance company picked by your employer, and it pays him with your money via premiums or foregone wages— "few doctors in America know the actual value of the services they render."

 

This is why it bothers me so much to find out that government bail outs are going to keep company's afloat that are producing inefficient, ineffective IT systems for health care that contribute to the problem instead of adressing it.

[westvirginia]

...

Anyone else know of an industry that raises prices by double digit percentages every year without any substantial increase in quality or efficiency?

 

Just government.

[bpwallace49]

It would appear that Mr. Bush from the article Az linked completely agrees with you and has started a very innovative IT company to correct the situation. From the article:

 

Oh I know . . . but then he goes on to blame the gubment, but mysteriously insurance companies are not mentioned.

 

If this whole health care reform actually went after insurance companies and encouraged more transparancy in medical billing practices, then it might actually benefit the consumers.