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Healthcare: One Person’s Waste Is Another Person’s Job Security

Someone I know works at a non-profit organization (supported by health insurers) that is trying to simplify the administrative processes in healthcare. He’s tasked with finding ways to make data transfer between doctors’ offices and health insurance companies more uniform and straightforward. His work is such a success that it was promoted to President Obama as a clear example of health insurers’ efforts to reduce waste and simplify healthcare. There is even talk of his project becoming mandated.

So why is this simplification strategy now in jeopardy of being tabled rather than legislated? Vendors and clearinghouses who exist to transfer data from one disparate health insurance bureaucracy and medical practice to another are fighting to block this progress because their business model is at risk. If health insurers and physicians can safely and efficiently exchange data – then they become less reliant on middle men.

One person’s waste (non-uniform, inefficient data exchange) is another’s (clearing houses and vendors) job security.

And we wonder why it’s so difficult to reform healthcare?


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