Restructuring The Medical Insurance Industry

December 15, 2022

Dr. Jerry Williams of Urgent Care 24/7 discusses health insurance and health care costs in general.

Reviewing the 2019 Congressional Research Service report - there are 323 million people in the US, and we spent $3.6 trillion dollars in 2019, on healthcare related expenditures 3.6 trillion. Dr. Williams is not exactly sure if my calculator is going to allow him to do 3.6 trillion, but we're going to try it. We've got 3.6 trillion divided by 323 million and that's $11,145.51 per person in the United States.

Now, that's taking all things into account, that's inpatient, outpatient, this is healthcare related expenditures. Think about this, from the research that Dr. Williams has done, approximately 30% of healthcare expenditures are administrative overhead. 30% of 3.6 trillion, which is going to be about a trillion dollars goes to overhead, which is the processing of claims, and the management of claims and so forth.

We certainly don't need to be cutting dollars to healthcare costs, but what if we could more efficiently manage our healthcare expenditures nationally as a country more efficiently with less administrative overhead? Now, the private insurance company CEOs that make 10s of millions of dollars a year in salary aren't gonna appreciate that. If we can take some of those dollars and operate our system more efficiently, and direct those savings towards improved and increasing access to care, for example, the roughly nine or 10% of the people in the US that have no coverage at all, no Medicare, no Medicaid, no private insurance of any kind.

What if we could insure those 10% with the savings and administrative overhead, and then everyone would have coverage? How cool would that be? Dr. Williams wanted to talk about how big the numbers are and what we're looking at, and how much administrative overhead or fat is built into that equation. So we can just have a discussion about how do we fix this mess this problem we're in?

Because it's a mess, he can tell you that we had Urgent Care 247, his urgent care company, which is a national urgent care company, we don't accept insurance, or third party payment of any kind, because most people are operating under their deductibles. 80% of all patients never meet their deductibles. So they're paying out of pocket anyway.

So why add the administrative overhead to that 80% of patients that 30% overhead? Why add that to the equation when we can for primary care and urgent care, low dollar expenditure underneath the deductible threshold, we can take care of these patients under here without that 30% overhead. That'd be a huge savings right there.

Dr. Williams thinks it's important that we have an open discussion and debate about topics such as this, but he doesn't you know, and he doesn't think anybody would argue the fact that it would be great if we could operate our healthcare system more efficiently and direct those dollars towards ensuring uninsured people and increasing access to care and increasing benefits direct health care to people who need it, and less to administrative overhead.

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