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http://timnerenz.com/content/counting-snouts



In my speech at the AFP Town Hall Meetings in August, I used the phrase “snouts in the trough” to describe trial lawyers and malpractice insurers. An apology is owed; no, not to them, but to all the other snouts who were not given their due.



When I go to see my doctor, he spends a few minutes with me reviewing my vitals, asking how I feel, and renewing my prescriptions. If I paid him $15 cash, he could earn over $300,000 at that rate; and I would cut my cost of health care by 80%. We would both be happy.



Michael Moore, if you are reading this, that is how capitalism works: a voluntary exchange makes both parties happy and everyone else minds their own business. But that’s not how health care works. Oh, no. There are a few more snouts in the trough and it is everybody else’s business. Let’s count snouts.



Just in case I might sue him (aforementioned trial lawyer and malpractice snouts), he sends me for some lab work (snout), and the results go to medical records (snout), then on to billing (snout) and to someone who writes me a letter with the results (snout). It contains some pamphlets on healthy living (snout) and a customer service response card (snout) so the clinic director can know if I am happy.



The bill for the lab work is sent (snout) to my claims processor (snout), who runs it by their fraud detectors (snout) and then checks the discount (snout) and in-network status (snout). If the claim is denied, then we repeat this loop several times (snoutis pluralis) until all the coding and paperwork is just so.



Then it goes to their payable department (snout), and they send a check to the receivable clerk (snout) at the clinic, and they send me a statement (snout) showing my bill was partially paid. My claims processor also produces an explanation of benefits (snout) that I can’t understand, and mails it (snout) to me. Once in a while, they send me a card (snout) to see if I’m happy. Ecstatic; thanks for asking.



The claims processor then sends a bill (snout) to my Flex benefits administrator (snout) for the amount of the co-pay that my claims processor doesn’t pay. The Flex people check my balance (snout) and send me a check (snout). The clinic sends me another bill (snout) for the balance and I send them a check. They process that check (snout) and send me a statement (snout) that the bill is paid.



Are you still with me? Our snout count is up to 26 if the claim goes through perfectly on the first pass, which doesn’t happen very often anymore. But remember, that is just for the lab work I didn’t need in the first place. Now we have to process the original office visit bill. No comment cards or healthy newsletter, so we only need to add 21 snouts; that puts us to 47. But wait, there’s more.



We are self-insured at my company, so there is no obscene profit of an insurance company to factor in to our snout count. But we do have a benefits specialist (snout), a health coach (snout), and people in HR (snout) who help me straighten out my wrongly denied claims. And we pay consultants (snout) who pay other consultants (snout) to advise us on how to set all this up in compliance with the government’s (that is a whole new trough) regulations for self-insured plans.



And then of course we have accountants (snout) who count our health care beans, and a law firm on retainer (snout) to help us stay in compliance with the government (I already did them) regulators and HEPA law. Bear in mind that those other firms with a snout in the trough also had their own accountants and lawyers and consultants and IT guys that could be added into the count - but that would be piling on.



And all of those snouts have to go to diversity training, and some pay union dues, and they go off to conferences where they learn the latest snout stuff, and if they work for the government they have too many holidays, vacation days, personal days, sick days, and work-at-home (yeah,, sure) days to keep track of. So they are out there just a-snorting and a-grunting and shaking the flies off their fat muddy backs even when they are not processing my bill.



By my count, that’s 54 snouts in the trough, not including the government snout factory that regulates all and mandates half of this insanity. God forbid an MD and a Ph.D. could manage to exchange $15 on our own; no, we need 54 cubicle jockeys a-heppin’ us to get it wrong.



And that, my friends, is what is wrong with health care. That is all that is wrong with health care.



That is how you turn a simple $15 exchange that any two crack-heads can accomplish unaided into a $175 cluster-grunt that takes 54 people with college degrees 6 months to get completed. And we make fun of crack-heads?



How about that public option/single payer idea? That just replaces my claims processor’s private sector snouts with government snouts. And if you think the GS-8 at HHS oinks more efficiently than the Anthem contractors over there in Bangalore, then you are probably one of those crack-heads I have newfound respect for. Plus they retire at 50, so we have to count double to pay for the pensioners.



Are they fixing any of this up there in Congress? Nope. Those guys are just vibrating in place trying to finagle a way to stick that $175 bill to somebody that doesn’t vote. When they are all done, it will be $350 and my grandkids will pay. There is not one snout coming out in any version of any Congressional reform bill.



These guys are all out of their minds. They had their chance this year to enact real health care reform; we get our chance again next November.



Vote Libertarian. Vote for Tim, Not Tammy.





Tim Nerenz is the Libertarian Party Candidate for U.S. House of Representatives from Wisconsin's 2nd District. To support Dr. Tim's campaign, please visit the campaign website at www.timnerenz.com.

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Comment by Ross Trottier on October 7, 2009 at 12:38pm
Brilliant! If only you were running in colorado.

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