And, it's pretty pathetic when insurance will only reimburse a simply alcohol and drug abuse screening that only takes a few minutes to complete once a year.
It's pathetic the level of influence money plays in the American health system. I knew it was bad before I started this job, but now I've gotten to see a bit on how a doctor/clinician/practitioner can't even suggest the patient take a breath of fresh air unless someone is going to pay for it. Unless you're tricksy and sneaky with the way your word your notes that get filled, if it's not on the treatment plan or an intervention stated on the referral don't even have the thought of doing it because insurance won't want to pay for the session, which causes you to lose billable hours, which lowers your productive goals.
Health care writers I know about have some very simple analogies. If I take my car to the shop, I get an estimate. If something unusal is found I get a call asking if I authorize extra money. I don't pay until the problem is (presumably) fixed.
In health care this is called "pay for performance" not "pay for procedure" Just think of an auto mechanic who charged for every thing she did to change a tire, for example. So much for putting the car on a lift, so much for raising the car, so much for removing the hubcap and so forth.
Another part is transparent prices. Weird situations are different but for the vast majority of common complaints, a posted fee schedule just like auto shops have for specified procedures would be a step forward.
There's actually steps like that going on not but just minimal steps. I can pay $25 to get diagnoses for cold, flu and the like from my local hospital mega-complex. But we need to go much much further.
And so forth.