Sentences to ponder

For every doctor, there are five people performing health care administrative support.

That's from Catherine Rampell.


For every professor, there are five people performing administrative support.

Okay, I just made that up. What's the real number?

Don't worry health care reform will fix things....Obama and Romney can't both be wrong.

I mentioned to my blog-reading assistants that one of them should do some research to double-check those numbers, they sound high to me. I hope they get on it after their break.

Insurance companies are evil profit-seekers that cause gross inefficiencies.

And so we'll make it a law that everyone must have insurance.

Hooray for Obamacare!

I'm not sure that the 5:1 ratio is as useful as it seems. If you click on the source link underneath the chart, you'll see that healthcare professionals include counselors, social workers, pharmacists, dietitians, physician assistants, lab workers and EMTs. These 2.5 million administrative workers are not just supporting the 500,000 doctors. They're supporting 6.3 million healthcare professionals.

Indeed if you look at the numbers behind the chart 1.4% of employees are involved in "Billing and posting clerks and machine operators"

Is this an outlandish number?

Or should physicians waste their time with clerical work?

And do the clerical workers in the private sector do more to avoid fraud and abuse then the public sector, which means that the private sector spends up to the point were the marginal benefit of clerical workers equals the marginal benefit.

Public sector spending, they spend what the political system gives them to spend plus a little for debt for the kiddies.

"in Spain, where a 1:1 ratio of doctors to support personnel is common. I've yet to see a practice so far in the US where the assistants didn't outnumber the doctors 3:1." Isn't that consistent with US doctors being paid so much more than Spanish doctors?

We have supposedly reasonably good data that Doctors income represent some 20% to 25% of total medical expenditures.

But this is a gross number and does not include the doctors payment of overhead and support personnel. doctors I know report that up to two-thirds of their gross revenues goes to pay these expenses leaving them some one -third to one half of their gross revenues. These estimates seem to be roughly in line with the data reported in this article.

Per doctor, or per care giver? These kind of numbers are the stupidity which results from looking at statistics out of context.

I'd love to see the numerator and denominator of that figure. But I am certain we'll never see that - because her data was deliberated framed so as to achieve that result.

I've worked in plenty of hospitals - there simply isn't that kind of waste, anywhere. But hey, when truth isn't the object, go do whatever you have to do to sell that story!

"I've worked in plenty of hospitals - there simply isn't that kind of waste, anywhere."

I don't think the implication is that it's "wasteful" (ie, that they're hiring extra staff when fewer would do), it's that they *have* to hire so many people to deal with the rat's nest of insurance company claim systems, and to fight the insurance companies for payment when necessary.

ie, the 'waste' is the existence of the mess of claim systems, and the habit of insurance companies to resist payment of approved procedures, etc.

Earlier I commented that I am skeptical about the 5:1 statistic. I was being kind. That stat is bogus. Looking at some of medical practices I've done work for, 50% of the revenue went to the MDs, 25% to the staff and 25% to rent, insurance and other general expenses.

If this 5:1 statistic was produced for political reasons, fine - that is the way the game is played. But if decision makers actually believe it, Washington's strategy to fight the war on medical overspending will no more effective than trench warfare was in World War I.

Folks according to the data behind the headline number 1.4% of the workers in health care are involved with billing. They are often the lowest paid part of the equation so they must be less then 1.4% of the total costs.

Figleaf if your insurance company was so awful why didn't you switch? Did you complain to your employer? What do you think will happen when the government tries to bend the cost curve?

Joe Hendry I took a quick survey of Docs, they tell me that it is very rare for an insurance company to approve a procedure and then fight payment. How many times has this happened to you or a family member. Do you have data to support this claim.

Yay! I think we found the only low-paying jobs on the planet that these people want to do away with!

Some "administrative support" is necessary, of course. Doctors aren't very effective at providing medical care in an unfurnished room with the lights off and no drugs or other medical supplies. And nobody wants them to have to answer their own phone or sit behind a desk waiting for patients to walk in the door. Administrative support exists so that doctors can spend their time making medical judgments and not restocking boxes of tongue depressors or asking patients if they are free next Tuesday at 4.

And an increasing fraction of the caregivers themselves are not "doctors" but some other kind of medical professional -- whether those are counted as "administrative support" or just left out altogether, it's misleading either way.

How is 5:1 a bad number? Would you rather have a highly-payed doctor do the work that support staff can do just as well at much lower cost?

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