One-third of me is over my head.

A study in Health Affairs last month looked at the amount of money that physicians (in private practice) spend on overhead costs of interacting with insurance companies. The findings were extremely interesting and show just how much money doctors spend on things outside of actual patient care. Perhaps the most striking result was that primary care physicians spend nearly one-third of income, including benefits, on paying for staff interactions with insurers.

One out of every three dollars.

This statistic is outrageous and should be more prominent in discussions about health care reform. However, if you read the statements from the American Medical Association, all you see are proclamations on how patients are best served by private insurance--and that the public option in Obama's policy proposals is a bad idea "for patients." All of this talk persists even though an independent analysis from the Commonwealth Fund has shown the potential for a public option to save as much as 30% through mechanisms such as lowering administrative costs. With 45 million Americans completely uninsured and millions more underinsured, decreasing health care spending that doesn't fund actual care should seem like a prudent option--one that is, dare I say, good for patients. (You know, like the ones who are not getting any health care because they have no insurance and can't afford out-of-pocket costs. Not to mention the people who have their health plans revoked due to post-claims underwriting and rescissions.)

It seems that political pressure has already caused the AMA to backtrack a bit. An email that I received from the Massachusetts Medical Society stated that the AMA has decided to avoid "closing any doors" in analyzing health care options. Regardless, I hope that more physicians step up to the plate and advocate for reform options that are good for the health of patients instead of focusing on options that protect physician pocketbooks.