HealthCommentary

Exploring Human Potential

When coders lose their jobs.

Posted on | August 15, 2018 | No Comments

Mike Magee

With health care now consuming close to 1 of every 5 dollars in America, it comes as no surprise that the sector is a major employer. No surprise either that many of those jobs deliver zero benefits when it comes to patient care. In fact, there are now 16 health care jobs for every one physician, and 8 of those 16 are non-clinical.

Were we to proceed with a centralized health insurance system, while preserving local choice and autonomy over care delivery, estimates are that we would shave up to $1 trillion off of our nearly $4 trillion annual health care expenditure. Of course that means many insurance agents, coders, billers, and data specialists would lose their jobs. What’s to become of them?

Likely they would follow the money. But how might that $1 trillion be best spent? The best answer is embedded in the startling fact that the U.S. is the only developed nation that spends more on health care than all other social services combined. These services – including housing, education, transportation, environmental protection, sanitation, safety and security –are all proven determinants of health.

Our under-investment in these societal underpinnings reflects the fact that we have spent the last 75 years fighting disease rather that promoting health. Long shot cures for a thin sliver of our population attract outsized resources, while the basics receive the cold shoulder and the stiff upper lip.

The low hanging fruit is all around us waiting to attract some of those coders and billers to fields that actually contribute to health rather than to the furtherance of human debt and destruction.

Let’s take one example: Transportation for the elderly. 52 million people, or 16% of the American population, are over 65.  Of these, 30% have skipped their doctor appointments citing transportation problems as the cause. Missed appointments cost the health sector $200 per incident and $150 billion annually by one estimate.

There are 76.4 million Baby Boomers with 10,000 crossing the age 65 threshold every day. By 2030, 21% will be over 65, and over 1/5 will be non-drivers, and 1/5 have no children to lend a hand.

Last year, one enterprising health sector veteran saw an opportunity and seized it. Mark Switaj, a 15-year emergency medical technician who had come through Boston College and Georgetown University created RoundTrip based in Philadelphia. Contracting with local providers and insurers, his computerized Uber like patient transportation system was able to deliver a 4% no-show rate.

Mark’s business is growing rapidly. He’s doing well by doing good. Imagine if we were able to re-direct that $1 trillion we’re wasting on non-real work in health care and apply it to community infra-structure. That would change America.

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