The aftermath of the Affordable Care Act brought another wave of cost increases in health insurance in 2016. In the wake of skyrocketing expenses and massive losses, the nation’s largest health insurer now says it regrets entering the Healthcare.gov marketplace at all.
Obamacare was designed to give all Americans access to health insurance. But industry experts told For the Record that the current model will never work as it is simply a government program consumed by layers of bureaucracy and cost over-runs.
“Well, the problem isn’t the doctors; the problem is the system where we expect a third party to pay all of our bills and your doctor has to spend twice as much time to see more patients just to pay the overhead,” Devon Herrick, a senior fellow at the National Center for Policy Analysis, said. “On average for most physician practices, between 70 percent to 50 percent of their revenue goes to pay the office clerks, the rent on the large building with the waiting room, the file space, you know, all the overhead because third-party payment is really a very inefficient system.”
William Short, CEO of the medical billing and processing company Ameriflex, said that the current system forces doctors to turn their practices into a volume game where they are forced to race from patient to patient simply to pay the bills.
“That primary care physician is dealing with the working capital/account receivable death spiral, and where the only way they’re going to have a chance of making their payroll, making the bills that are due, is by seeing as many people as possible,” said Short.v”The reason they have to churn through it has been when they see a patient today and that by the time they pay someone to file a claim, and by the time that claim is repriced by the government or some other third-party payer, it’s 30, 60, maybe 90 days before they get paid. So how do they keep ahead of that? They got to see more. It’s like the classic, you know, death by volume, I’ll make it up in volume. Well, who suffers? The patient suffers.”