More on the Health Care Debate

One of the --frankly--sillier things I have heard from critics of a government health program is: "I don't want a government bureaucrat coming between me and my doctor."

As opposed to an insurance company bureaucrat?

Let us examine the presumption that a government bureaucrat (as opposed to an insurance company bureaucrat) is not competent to adjudicate billing and fee issues between physician and patient.

First of all, the government bureaucrat will likely know what he or she is doing. To get a job, a government employee must describe and document KSAs (Knowledge, Skills, and Aptitude) for the job in question. Getting promoted also requires either documenting KSAs or performing elements of the job at a higher level of performance to the satisfaction of a superior; just ask anyone who has ever applied for a federal position. By the way, the federal KSAs are public record.

On the other hand, the insurance company bureaucrat may have no experience whatsoever. There is no way to tell.

The government bureaucrat has little incentive to deny a claim for cost reasons, because his or her job performance is not measured by bottom-line considerations. Rather the government bureaucrat's work performance is measured against performance-based objectives including speed of processing claims, accuracy, judgement, client satisfaction.

The insurance company bureaucrat is very much judged on how much money he or she save the company (read; number of claims denied).

In our current system, you have an insurance company bureaucrat between you and your doctor; who may have worked at a Kentucky Fried Chicken last week and is, in any case, not working for you but for the company's bottom line.

I'll take the government bureaucrat.