Look for waste to pay for health care

Fencepost published a letter from Ms. Carey-Wolff about the time and effort that doctors and hospitals spend trying to obtain payment for patient services already rendered - from insurance companies.

She has touched on one area where change to the system would result in savings. I have spent my entire professional career working in and around the insurance industry. I believe significant savings could be realized in these areas:

1. The insurance industry should be asked to provide information explaining how much of the system (in dollars) is spent in denial of claims;

2. "Managed care" middlemen (who originally created the doctor/provider networks) are middle men who do not add value to the system - much of what they do can and should be done by computer;

3. Billing and rate setting is already taking place. It should be systematized to avoid serious inequities;

4. Executive pay should be scrutinized, outed and controlled. Why should the CEO of a "not for profit" insurance company be paid millions and then given millions more for retiring.

Wouldn't half a million a year plus a potential bonus of up to 100 percent be enough to attract some very qualified execs?

Illinois has a "claim handling statute" which prohibits certain practices. Unfortunately, the courts have interpreted the statute as not allowing for a private right of action. This means only the Insurance Department can bring enforcement actions against companies that violate this Law. Anyone heard of this happening lately?

Insurance should be a right. There is much waste in the system which could pay for much of the needed reforms. Why aren't our legislators looking at these issue?

Brian V. Gray

Mount Prospect