> They still pay health care workers, but they don't have to have phone banks filled with people answering questions about claim denials. I'm not even sure if a claim denial is a thing here, or who I would call.
The Canadian system may be much cheaper to administer, but it isn't magical. There is still a need for staff to administer and adjudicate claims, and you still have to ration limited healthcare resources somehow.
Notice how all of the things that you found represent a single department in the provincial government instead of a significant part of national GDP spread across multiple billion dollar conglomerates.
The first link you submitted is actually showing how the automated system processes the huge majority of claims automatically without people in the loop. So not a good argument that BC has phone banks of people answering claims questions.
Yes the claim process exists, and the various appeals parts exist, but that part of MSP is just not the patient's problem. If you read through the reasons for denial that you linked, almost all of them are requests for better paperwork or missing information. The level of administrative overhead just doesn't exist on the scale that I have experienced living in the states.
What I have never had happen, or heard of happening, is a resident getting a bill for seeking medical care (which would happen if a claim was rejected). Or someone not receiving medical care due to inability to pay. Or having to doctor shop for a place that accepts their insurance. In fact, most people I know have never even had to contact MSP.
>The Canadian system may be much cheaper to administer, but it isn't magical. There is still a need for staff to administer and adjudicate claims, and you still have to ration limited healthcare resources somehow.
But it isn't just the Canadian system -- it's every other system too.[0]
There is a unique form of corruption occurring in the American health system and it is absolutely tied to the insurance industry.
This corruption causes the misallocation of resources in ways that are detrimental to the health of American citizens.
Medical bankruptcy and the cost that it has on a person's health isn't really a thing in Canada. Having to choose between paying for medical bills or healthy food isn't really a thing in Canada. People putting off minor medical issues until they grow into major issues because they can't afford routine checkups or treatments isn't really a thing in Canada.
This results in far less rationing of healthcare because people are able to make better choices that prevent the waste of medical resources.
Don't get me wrong, there are issues with Canadian healthcare -- the biggest being corrupt politicians and business people trying to import American healthcare practices for their personal gain but the issues that the average Canadian face in accessing healthcare are nothing compared to those that the average American faces.
There certainly must be people doing all of this claims processing, maybe not an "industry" since it's part of the government: https://www2.gov.bc.ca/gov/content/health/practitioner-profe...
> They still pay health care workers, but they don't have to have phone banks filled with people answering questions about claim denials. I'm not even sure if a claim denial is a thing here, or who I would call.
There's a long list of rejected claim codes for BC here: https://www2.gov.bc.ca/gov/content/health/practitioner-profe...
And a support center for handling questions and disputes: https://www2.gov.bc.ca/gov/content/health/practitioner-profe... And an appeals process: https://www2.gov.bc.ca/gov/content/health/health-drug-covera...
The Canadian system may be much cheaper to administer, but it isn't magical. There is still a need for staff to administer and adjudicate claims, and you still have to ration limited healthcare resources somehow.