Replying to a message of Jeff Binkley to Sean Dennis:

 JB>>> I'll contend it is broken because of bureaucracy and we use a
 JB>>> third  party payer system where the person receiving the service
 JB>>> isn't the  person paying for it.

 SD>> I can agree with that too, but my "greed" angle comes
from how the
 SD>> medical community overcharges for a lot of things, such as tests, et
 SD>> al.  But I know that malpractice insurance is sky-high too.

 JB> I agree they have some terrible billing systems and do overcharge.  I
 JB> am  just not sure it is due to greed as much as administrative
 JB> incompetence.

In 2004 I got an ambulance ride from the ER at the (former) Offutt AFB
hospital to a civilian hospital 7 miles away.  I received two EOBs from
Tricare indicating payment to the ambulance company.  The reason they
got paid twice is because Tricare (and Medicare) is so d*mn slow in
paying claims that the provider sends them a reminder, and that eventually
gets paid too.  Medicare (and Tricare since it's basically the same system
with a different clientele) has for decades been notorious for slow payment
of claims.

In my case I wrote a note to Tricare pointing out that there was only *one*
ambulance ride that they had paid for it twice; got a nice letter back from them
thanking me for pointing it out and saying that they'd taken steps to recover the
overpayment from the ambulance company.  I suppose the ambulance company
was not amused; while they *should* have returned that second check when they
got it I'd bet good money that absent my letter to Tricare they would not have.
That was one tiny item amounting to a couple of hundred dollars; multiply that
by hundreds of thousands of clients each of whom have multiple claims and 
you're into some serious money.


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