Single Payer Health Systems

We have a medical charity group that operates in NE FL (maybe elsewhere too, don't know) called St. Judes. They are a charity that helps people get medical care as one of their missions. They would contact our office and want to arrange services for a patient. All the services related to a specific thing were to be included in the price, no patient billing. I can't tell you how many times I got calls from St. Jude or Managed Care because one of our clinics/hospitals/Imaging centers was billing a St. Judes contract patient. Clinics are not used to coordinating care and suck at it. We (Patient Services) always had spreadsheets and work queues going to track , maintain the accounts, stop the billing to the patient, bill St. Judes, ensure proper resolution. I worked for a large healthcare organization, part of Univ. of FL, and we took this seriously and still had constant issues with groups like anesthesia, radiology & labs not being included in quotes, but providing services. Medical care is so fragmented with so many providers giving services and wanting compensation, it would be almost impossible to provide accurate quotes for a whole host of procedures. My area had to take over giving quotes because the clinics were so bad at it and we coordinated with the hospital where our physicians worked and things improved substantially, but that was just for advance scheduled services and didn't include any patients from ER. Most hospitals and physician billing groups don't have a dedicated team of people to provide quotes including all services for one thing, for two - medical isn't a totally exact science. Physicians think one thing is the issue, open you up and there's something else going on as well - what do they do? In most places, their ethics say they have to fix the unexpected problem they found. Then they bill for what was really done vs. what they thought they'd be doing and the cost is different. Unless there is only one group doing joint healthcare billing for everything, i don't see how this can work effectively and I worked in the industry for 20 years dealing with these issues.