The Troika That Benefits From Complexity In Heath Care Financing

Arvind Cavale | Rebel.MD | July 7, 2014

My good friend, Dr. Herb Kunkle, has aptly coined the term, “The Troika” consisting of hospitals, insurers and the government. He frequently and passionately talks about how this Troika is sucking up health care dollars as well as decision-making in health care. A recent NY Times article describes just one dizzying example of the collusion between hospitals, insurers and government and the costs this Troika puts upon taxpayers and health care consumers.

The burdensome complexity of medical billing and collection, intentionally designed into Medicare via federal mandates, creates a whole new billion-dollar industry of “consultants”, who “help” hospitals be “compliant” with Medicare rules, so they can get paid the “appropriate” amount of dollars for their services. Never mind that these consultants actually work for a large insurance corporation, which also provide Medicare Advantage Plans to seniors. Never mind the fact that this same company is one of the main contractors for Their job is to “support(s) Medicare’s aim to save money”. We just have to take the insurance companies’ word that there is no conflict of interest here!

While complaining about the costs of American health care system, has anybody calculated the toll of these shenanigans on patients or their doctors? Have any of the top financial firms (hello PWC, McKinsey) calculated the real cost of the artificially created complexity in paying for health care services?...