Better system will save money

I am a 36-year veteran registered nurse. I have been hospital based, managed a family practice and managed large-dollar medical care for a huge health insurance company.

I have seen both sides of healthcare delivery and payment. I can tell you that it has become almost impossible to provide quality health care and get properly reimbursed or understand for what and to what extent any health insurance company is contractually liable to pay.

Doctors and hospitals spend huge sums of money to employ people to bill insurance companies for services already extended to patients, and even larger sums of money employing people to get insurance companies to pay for those services according to their contractual obligation with those patients.

Insurance companies spend unimaginably enormous sums of money to employ people to deny the legitimacy of those already-given services, mishandle claims, negotiate with healthcare providers greatly-reduced payments in exchange for not holding up payment.

Just imagine if all of those resources weren't spent that way because all U.S. citizens had health insurance, that what was written into a health insurance policy as covered was straightforward and paid accordingly.

Why, doctors could actually lower their fees. Hospitals could lower their charges, health insurance companies would not be able to pay upper-level executives multimillions of dollars because they would be required by law and by a public option competition to uphold their contractual agreements with insureds.

Personally, I have spent hundreds of hours holding on the phone either as a nurse or as a patient waiting to talk to a "customer service representative" about correct payment for a health service. Hours of time that I could have better spent teaching diabetics how to prevent leg amputation or doing any one of a million things that RN's do best.

I am ready for a system that works better for all patients than for the health insurance companies.

Janet Carey-Wolff

Barrington