Exactly! That's my point - if it was really just a relationship between a patient, a provider and a payor then that would be cool - but because we're talking about the US Federal Gov't, it is NEVER that simple! As Magick said - we don't even trust our gov't to correctly fill a pothole in an reasonably efficient manner, let alone handle our healthcare system. Picture this: A long trough. At one end is the patient that needs healthcare. At the other end is a big vat of taxpayer money being poured into the trough. In between is a loooong line of pigs with their snouts buried in the trough, gobbling as fast as they can. Not much makes it to the other end!
Here's another little tidbit: The insurance companies that are contracted to do the Medicare claims processing make more money when they pay out less money to the providers. Hmm, is it then really a surprise that the rules for submitting claims are ridiculously complex and the rejection rates of claims are high? The processors are willing to spend a significant amount of money to nitpick every claim - and then call it "quality control review" and "fraud prevention". I liken it to the TSA - willing to strip search old people and small children in order to look for the one in a million terrorist.