Dozens of studies of federal and state single-payer proposals have found that single-payer plans could provide universal coverage not even the ACA does that and still save money. Estimates of the administrative costs of commercial health insurers exceed 10%. That doesn’t include the costs to doctors and hospitals of maintaining billing staffs to deal with insurers and keep all their rules and peculiarities straight, or the time lost to individuals and their employers of navigating this unnecessarily byzantine system. Add those, and the overall administrative costs embedded in the U.S. healthcare system come to 31% of all spending, according to a 2003 article co-written by Himmelstein for the New England Journal of Medicine. Administrative and clerical workers accounted for nearly 44% of all employees in doctors’ offices, they calculated.
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Health law could overwhelm addiction services
The shortage is especially acute in impoverished inner cities and rural areas, where it already takes many months, years in some cases, to hire doctors, health professionals say. Im thinking about putting our human resources manager on the street in one of those costumes with a We will hire you sign, said Doni Miller, chief executive of the Neighborhood Health Association in Toledo, Ohio. One of her clinics has had a physician opening for two years. In southern Illinois, the 5,500 residents of Gallatin County have no hospital, dentist or full-time doctor.
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Patients gaining coverage under health law to further strain shortage of primary care doctors
The government is also pressing states to expand their Medicaid programs to include more working poor people. If 24 states expand their Medicaid programs roughly the number now planning to do so an additional 4 million prospective patients with addiction problems would get insurance, according to the AP analysis. If virtually all of the states eventually decide to expand, as federal officials predict, the ranks of the newly insured with addiction problems could reach 5.5 million. Perhaps as important as the expansion, the new law designates addiction treatment as an “essential health benefit” for most commercial plans. “This is probably the most profound change we’ve had in drug policy ever,” said Michael Botticelli, deputy director of the Office of National Drug Control Policy.
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