The hogs at the trough have net profit margins of 5% or less, and pay out 85%+ of premiums they collect to healthcare providers. You can remove MCOs from the equation, and their function will still have to be done by whoever is paying. For example, the approving/denying is still done in the UK even though they have taxpayer funded healthcare. Or even within the Kaiser health system in the US.
It does make life easier for providers and patients when there is one system that provides quick definitive answers rather than back and forth. On that front, there is much improvement to be made in electronic communications between healthcare providers and MCOs.
On a positive note, this is happening via electronic prescriptions and integrated EMRs. I have seen my kids’ doctor pull up covered medications in their system and then quickly sending the electronic prescription to the pharmacy.
> But I'm sure this would create other problems and snarl the system with even more complexity.
There is absolutely no reason for employers to be involved in your healthcare. They currently are able to use it as a leash around your neck because paying for MCOs via your employer means you get to purchase with pre tax dollars. Paying yourself means you have to pay with post tax dollars. I am looking at my box 12 code DD total, and for me that is $32k of insurance premiums I was able to pay with pre tax dollars.
More importantly, it gives employees an additional hurdle and fear of changing employers, because what if they have to go through what the person who wrote this article did? Maybe they should not shop around to see if they can sell their labor at a higher price, and just stick to their current employer. Another unnecessary chip for employers to have over employees in the US.