The Great Health Insurance Mystery

November 7, 2009 | Filed Under Anti-Americanism, Barack Obama, Budget, Business, Capitalism, Congress, Constitution, Democrats/Leftists, Economy/Finances, Free Trade, Freedom, Government, Corruption, Health, House of Representatives, Liberals, Media Bias, President, Socialism, Society/Culture, Taxes, Vince Johnson |

-By Vince Johnson

I had a dream that several respected members of Congress tried to prove this bulletin was misleading and I quietly smiled when they gave up and went out to lunch.

There is no mystery in the fact that Congress wants the government to be the only source for health insurance for over 306 million Americans. However, there is great mystery in understanding why politicians do not realize that such an eventuality is bureaucratically impossible.

Consider established facts: The Social Security Administration requires 62,000 employees to process applications, issue SS numbers, manage existing accounts, and disburse monthly payments to 50 million retired folks. The total U.S. population of people over 18 is about 230 million. Assuming these people have SS numbers, it is reasonable to say that in any given month, the SSA is handling the accounts of 280 million people including 50 million retirees.

Keep the above in mind as you consider what Congress will be coping with when the government becomes the sole provider of health insurance.

According to the American Medical Association, there are over 700,000 active physicians in the United States. Most doctors see 25 to 35 patients per day and many up to 40 or more. If they averaged 25 patients per day, this would generate a national total of 17.5 million appointments a day or about 379 million claims a month for office calls only. Orders for X-rays and lab tests, etc. would increase the average claims to 1.5 per visit bringing the total medical appointment claims per month to 568 million per month.

According to research published by IMS Health Inc., in 2008 the top 15 pharmaceutical manufacturers dispensed 3.8 billion prescriptions in the U.S. This would average at 316 million claims per month for prescriptions. Add 568 million claims for doctor visits and you get 884 million per month.

According to the CDC/NCHS National Health Statistics Report in 2006 over 6,000 U.S. hospitals provided 46 million procedures and had 34 million patient discharges (excluding newborn). Hospital bills have multiple charges that will need detailed review before the claim can be approved for payment. Each claim will involve a complex compliance process as required by some of the services provided: EKG’s, MRI’s, ER services, colonoscopies, gynecology services, imaging, ambulance, transfusions, dialysis, CAT scans, endoscopies, amputation, obstetrics, pediatrics, imaging, rehab, anesthesiology, and on and on.

At a minimum, monthly volume of hospital claims including obstetrics is estimated at 25 million per month. Add 568 million claims from doctors and another 316 million claims for prescriptions and you have an average of 909 million claims per month!

(When government insurance covers abortions, the claims per month will increase further.)

How many bureaucrats will it take to receive, sort, review, reject, accept, disburse and archive 909 million medical insurance claims per month? Based on the 62,000 bureaucrats required to manage 280 million Social Security accounts per month, the answer would be a whopping 201,284 bureaucrats to manage 909 million medical claims per month. That’s 4,516 claims processed and approved per bureaucrat per month or one every 1.5 minutes! The mystery of the matter is colossal! How can Congress possibly believe each of 201,284 bureaucrats can handle 4,516 claims per month when it takes 1.5 minutes to process each claim and do it without error 8 hours a day, five days a week, month after month?

In 2008 the Social Security Administration included 10 Regional Offices, 37 Teleservice Centers, and approximately 1,300 Field Offices. The task of visualizing a new bureaucracy three times bigger than the Social Security Administration is mind boggling and it brings up some hardball questions:

How much money is “saved” when the government loses billions in revenue from taxpaying insurance companies after they are replaced by an inexperienced bureaucracy costing billions to establish and billions more to operate?

After Congress uses $500 billion Medicare funds to start up this new bureaucracy, how much will the government have to charge senior citizens for health insurance premiums for claims previously paid for by Medicare?
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Vince Johnson welcomes comments. Please send them to,Vince Johnson(vjadtrak@wvi.com)
See Vince in the new book Americans on Politics. Policy, and Pop-Culture.

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