[ceejayoz]

> It literally breaks practice and net cost of insurance out!

But it's not a "Cost of Health Insurance" item. It's an expense at the practicioner level! They have to factor that non-billable time into what they charge for the procedure!

Read their definitions: https://www.cms.gov/files/document/quick-definitions-nationa...

"Administration" is the insurer's side of it.

[tptacek]

This is special pleading.

[ceejayoz]

Oh, now who's dodging?

If an insurer manages to double a doctor's administrative costs for billing/appeals/etc., where does it show up in your tables, per your link's PDF of definitions?

[tptacek]

You have no evidence for this argument. It's just vibes. The numbers here are stark. It's not like it's close, between providers and insurers. Insurers are almost literally a rounding error.

[ceejayoz]

You asserted "the macro NHE table from last year… simply refutes the argument you're trying to make", but that claim is false. You are welcome to answer the question about where "doc spends two hours on phone arguing with UHC" falls in the expenditure list; it's not insurance, but it's caused by it.

> Insurers are almost literally a rounding error.

Again, the argument is that the raw cost of health insurance does not reflect its externalities imposed on the other items in your list; that insurers drive up hospital and practice costs, as they have to staff up enormous amounts of staff and expensive physician time to deal with the insurer.

[tptacek]

$360B in admin/net cost of insurance. $2.5T in practitioner costs.

[ceejayoz]

> $2.5T in practitioner costs.

Some of which is those practicioners' admin cost from dealing with the insurers. (And, you know, doing the actual work.)

Denials are nice and cheap. Fighting them is not.