It's not government that insists on pre-approving treatment, it's the private insurance companies. Many doctors keep extra nurses on staff to deal with insurance company pre-approvals. They also farm out billing to third party companies because it's too time consuming and too complex. Many doctors refuse to deal with insurance companies at all because they are too intrusive in patient/doctor care. Patients pay out of pocket and then fight it out for their insurance companies for reimbursement. Billing and Administration is the largest department in American hospitals.
I live in a country with government funded health care. I have no paper work to complete, no forms to file for my care. I have a health card I present at the doctor's office and at the pharmacy for prescriptions. My only role is to hand my card to the doctor's receptionist or the pharmacist so they can verify that I have coverage. That's it. There are no pre-approvals. Billing is done once a month (single payer so it's only once invoice), by the doctor's receptionist. So while Canadian doctors don't make as much money up front, they don't need additional staff to deal with insurance companies, nor do they need third party billing and collections, and they get to spend more time with patients.
Our health care costs are almost half of what the US spends, and out administration costs are below 10%, while yours are over 30%, based entirely on levels of scrutiny and complex billing practices put in place by private insurance companies.
The problem is that they are HIGHLY regulated by government. You left that part out. We can't even shop across state lines for insurance. Plus Medicare, Medicaid, lots of red tape. Lawsuits up the ass due to our litigious society with lawyers more plentiful than rats.
You paint a rosy picture but I've heard some less than stellar things about your healthcare.
No health care system is perfect but yours is a snake pit for all who use it. Here's a clue, all that paperwork that has to be submitted by claimants and their physicians is an expensive waste of time. More money is spent to prevent waste and fraud than the waste and fraud would cost. The paperwork surrounding your medical system keeps people from making claims, which is as was intended. Give users a photo ID swipe card and have them present it each time they access the system.
Everything about your private insurance plans is designed to make claims difficult to file and difficult to get approved. All that obstruction costs money - money for the physicians, and money for the hospitals, and aggravation for sick people who should be focused on getting well.
And you are not making any proof of your statements. Totally personal subjective statement!
YOU need to do a little more research before spouting your crap.
FACT... Less then 7% of the claims filed are denied by the top five companies.
Fact federal law requires at least 80% of all premiums MUST be paid out in claims.
The Affordable Care Act holds health insurers accountable to consumers and ensures that American families receive value for their health insurance premium dollars. One such mechanism is the 80/20 rule, or Medical Loss Ratio (MLR) rule. The 80/20 rule brings consumers value, increases transparency and accountability, and promotes better business practices and competition among insurance companies.
https://www.cms.gov/CCIIO/Resources/Files/Downloads/mlr-report-02-15-2013.pdf
Health insurance companies deny too many claims.
View attachment 69257
FACT:
For this report, CAQH collected an extensive quantitative dataset on major administrative transactions through its initiative, the U.S. Healthcare Efficiency Index® (Index). Health plans representing over 100 million covered lives contributed to the effort.
The dataset includes information from over 1 billion claims and 3 billion transactions.
In cooperation with Milliman, Inc., we also surveyed healthcare providers and health plans on the costs of manual and automated transactions, based on publicly available information and proprietary Milliman cost data.
http://www.caqh.org/sites/default/files/explorations/index/report/2013Index.pdf
READ the report and then come to logical conclusions!
I am an expert by the way as 10,000 times a day health care providers come to a service I provide that verifies the eligibility of the patient.
I KNOW EDI.
I know how health care claims are filed and I know you do NOT have the level of understanding that I have gained over the last 20 years!
So please read the above study. Get educated before doing as Lincoln said:
"Better to remain silent and be thought a fool than to speak out and remove all doubt!"