[nine_zeros]

Price aside, the biggest problem with American health care system is the administrative black hole at every stage.

Wife was on some serious (and expensive) medical treatment. After many months, the medical provider was at the final stages of the treatment. As usual, the provider needs insurance approval for arcane codes that constitute that segment of the treatment.

Get this, the medical provider applies for approval using a FAX. There is no acknowledgement or online tracking. And the authorization is received back using FAX. What a joke!

My wife didn't hear about the treatment for 3 weeks. Under pressure, she called her insurance. Insurance says, they didn't receive any request for authorization.

Why the fuck didn't the medical provider follow up? Exact question asked by my wife. Medical provider's explanation was that they faxed and were just waiting on insurance. They just sat on their fat bums while the time was running out.

So, wife patiently asked medical provider to apply for authorization again. The provider said they sent another request right away.

Another week later, wife had to call insurance again to find out that they STILL DID NOT receive any request.

Distraught wife asked insurance rep to call the medical provider immediately. Of course the call went to voice mail.

Wife then called the medical provider and left a scathing voicemail, threatening to sue. Only then this system worked miraculously. It still took a day for the medical provider to figure out what was wrong with their fax system. It still required my wife to follow up with insurance asking if they received the authorization request. Then 3 days later, the insurance provider approved the authorization and my wife had to call the medical provider again to confirm that the authorization was received.

All good now? Ohhh Noooo. Now the medical provider placed an order for medication that needs to be shipped from a pharmacy in another state. And they do place it. Now my wife gets a call from the shipping pharmacy to schedule a delivery. The delivery happens after 3 days.

Wife checks the delivery. Oops, it is missing a few items required for treatment. Guess what she needs to do to get the missing items delivered? You guessed it. Have the medical provider do the authorization process ALL OVER AGAIN.

Oh, and every call to the medical provider goes to a voicemail to which they take a minimum of 8 hours to reply and every call to insurance has a 30 min elevator music. Imagine all this 10 times in 3 weeks and that was just one round of shipping and nervousness.

Fuck American Healthcare.

[agumonkey]

Some countries have been jumping so far ahead. IIRC Slovakia, Iceland have ultra lean administrative processes in lots of places. Minutes instead of days or more, and non hassle. UK has some of that too.

France is starting.

Someone in the US should get funding for this. It's a 300M people's "market".

[nine_zeros]

I highly recommend healthcare in Asia. In most asian countries, healthcare is pure market driven. Aka, most people are uninsured so there is no insurance bureaucracy. No contracts, no lawsuits. The reputation of service and doctors matters. Appointments for this afternoon? No problem, you got it.

American healthcare is what I would wish on my enemies.

[agumonkey]

All asian countries ? china ? japan ? india ?

Any book about their systems ?

[nine_zeros]

Systems and prices vary between countries. No idea if there's a book but my experience in Indonesia, India and Vietnam was stellar. Working with a medical facility was as simple as doing something in a mall.

If you are going from America, you can't go wrong in any major Asian country. India has the benefit of having English speaking doctors.

[agumonkey]

And how do they implement quality control ?

[nine_zeros]

Who is they? And define quality control.

[coffeefirst]

And to make matters worse, all this bureaucratic nonsense for coding, billing, authorization costs a stupidly large amount of money that gets baked back into the bills somewhere.

[nine_zeros]

Oh yes, you get to pay $500/mo insurance premiums and $2000 deductible and lots of copays for the privilege of using this masochistic system.