The Defective DHHS System:

Below, I've outlined the BIGGEST reason why US health care is out of control - DHHS management's inability to see what's going on.  In further articles I'll outline other important reasons - but none as important as this.

The big picture DHHS doesn't see - There are five million (5,000,000) legitimately operating health professionals in the United States.   Over two dozen categories of US health professions, representing over two million of the five million, are allowed by law, to bill directly for their services. But DHHS has only authorized codes used for Medicare, Medicaid, and the health insurance industry, that are developed by, and for, MDs.  And the majority of these MD codes represent THE MOST EXPENSIVE, DANGEROUS, and INVASIVE procedures available which are also frequently THE LEAST EFFECTIVE.

There are NO CODES, or inadequate billing codes, to process healthcare claims provided by the over four million health professionals who aren't practicing conventional MD medicine.   How do these practitioners stay in business when they can't bill?  They either work under an MD physicians, their patient's pay cash, or their care is capped by small annual dollar or visit limits - and no data is available on the cost-effectiveness of their care. 

Obviously, if we had codes available that reflected ALL billed care from ALL health professions, we could make comparisons about what is and what isn't cost-effective.

Not only are currently available codes limited to procedures provided or directed by medical doctors, but these medical codes are further limited to services "approved" by the AMA - which does not recognize services that other qualified caregivers legally and effectively provide.  Leaving the AMA to decide what's good in osteopathy, chiropractic, massage therapy, physical therapy mental health, etc.  -  health practices they have no knowledge of, or training in - is like putting the fox in control of the hen house.

MDs have over 8,000 codes to use for billing while the government and the AMA dole out a few token codes to osteopaths, nurses, chiropractors, acupuncturists, massage therapists, etc.  Obviously, we need a complete set of codes for all professions, written BY THOSE PROFESSIONS, so they can bill directly for their services and compare their costs and outcomes to MD outcomes.

So, let me say this again. We get very limited access to those 4,300,000 less expensive health professionals because of codes.  So, our costs go through the roof - day by day.  Worse, only those existing codes are available to track what's happening in health care - making it appear that ONLY MD health care is of any consequence.

Get the idea? 

How it works - DHHS contracts for jointly developing billing codes with the American Medical Association (AMA), which owns the rights to Current Procedural Terminology (CPT) codes.  DHHS consults with no other professional organization except the AMA.  They ONLY work with AMA staff.  Nobody else, no other health practitioner category is represented at DHHS.

The AMA doesn't charge DHHS anything for the use of the CPT codes, but gets to charge a bundle for the use of their codes to the health care industry. Use of CPT Codes is the largest source of income for the AMA - towering above membership dues.  Everybody has to pay to use them:  Doctors, insurance companies, hospitals, etc... over 70 million dollars ($70,000,000) a year  in 2001 - probably twice that in 2007.

Those licensed and qualified practitioners who have NO CODES, or inadequate codes, and no representation at DHHS, include Behavioral Health Professionals, Osteopaths, Chiropractors, Homeopaths, Nurses, Pharmacists, Physical Therapists, Naturopaths, Acupuncturists, Nutritionists, Dieticians, Massage Therapists, Midwives, Occupational Therapists, Optometrists,  Alternative Medicine Practitioners, and more ? over 2,300,000 of them.

Let me help you let that soak in - 2.3 million licensed, legitimate health care providers in the US have NO CODES or INADEQUATE CODES to bill Medicare, Medicaid, and/or the rest of health insurance payors.

And another two million other legitimate non-licensed health care providers (Registered and Vocational Nurses, Sports Therapists, Herbalists, Traditional Naturopaths, Spiritual Counselors, Reflexologists, Curunderas, Native American Healers, etc.) have NO CODES to effectively document what they do.

Important - Eighty percent of health care costs, nationwide are "non-critical care" issues not requiring medical (MD) intervention, but the current system forces those patients to seek care from the highest price health care providers (MDs) first, and makes MDs gatekeepers for all other health care providers - even though those health providers are allowed, and encouraged, by Federal law, to operate independently (and more cost-effectively). 

So, because of a "sweet deal" between the AMA and current DHHS management, in defiance of the US Congress, only 14% of US health care providers have codes to report services to Medicare, Medicaid, or other insurance. 

Eighty-six percent (86%) cannot. 

It gets worse...

The medical system monopoly (the 14% of total health care offered), governed by DHHS, itself is a deadly rip-off of gigantic proportion.  A recent study, a compilation of other recent studies, called "Death by Medicine," says: 

"It is evident that the American medical system is the leading cause of death and injury in the United States. The total number of iatrogenic deaths shown ... is 783,936. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.^"

2,036,884 Americans die each year, unnecessarily, simply because the system OFFICIALLY bars eighty-six percent (86%) of US health professionals from participating in it - offering services that work.   And no one running the system cares.  No one. 

The Truth is - Effective and inexpensive cures for heart disease and cancer in the US are being suppressed - and of course there are no billing codes for these treatments.  There are so many different options available, I couldn't take the space to name them all and there are volumes written on these cures.  The point is, Americans are being cheated.  Greed and stupidity reign.