The healthcare system is messed up. We all know it but what exactly does that mean? Here, we’ll explore some of the elements of our insurance industry, the ugly parts that no one wants to talk about.

In today’s world many people have a general idea of what fraud is… When fraud comes to my mind, specifically medicare fraud, I think of the $4,000 leg brace sent to my friend though medicare that he didn’t need and didn’t ask for. Last I heard it was reported via the fraud whistleblower system but nothing ever came of it… When I think of waste I think of the doctor running up unnecessary tests, justified by him not having seen the patient in a while… Abuse is in the middle land between fraud and waste where there may be legitimate coding games going on, fudging numbers either knowingly or unknowingly, sending bills to increase what they already have, etc…

A kind of waste not as well known, can lie in Administrative waste. These clerical errors can be fairly common, and may be eliminated or at least reduced with the right checks and balances… All of this highlights many ways that the system can be exploited. However, there is another idea I came across lately and that term is Recondite. Recondite is defined by Webster’s dictionary as follows:

1
: difficult or impossible for one of ordinary understanding or knowledge to comprehend :
2
: of, relating to, or dealing with something little known or obscure
3
: hidden from sight : concealed

I would submit to you that Recondite is an acceptable practice within the insurance systems. If you think about all the parties involved in an insurance agreement – each party can easily become complicit to recondite on some level. The insurance executive thinks to himself, “I can’t tell them everything that I know or they will take advantage of me”. The employer thinks, “I can’t tell them how much I’m willing to pay because they will charge me too much”. The broker may not disclose how much he is working for on behalf of the insurance company and what he may know to be questionable deals offered. The employee may not be upfront with what he needs insurance for. You get the idea. Everyone around the table has a contribution to recondite because they don’t want the other party to know what they do.

Another way to think about recondite is in the context of Scripture. God is recondite. He does not reveal his secrets to everyone. It takes time and developing a relationship in order for him to reveal his secrets in his time. At the end of the day everyone must have the humility to admit that we don’t know what everyone else knows. And that there is a process to discovering more knowledge.

This is where a company like ours can come into the picture. We can open up the kimono and lay everything out for everyone to see. This, of course, may ruffle some feathers and bring up some unpleasant conversations. But in order to get the best options available, there needs to be someone who has the experience, knowledge, and grace to ask the right questions and break down the walls of recondite between each other. The process of doing this is no easy task as you can imagine. Everyone involved may not want to own up to their own recondite or disclose what they may know. However, we have the experience and technology to uncover the recondite by asking the right questions and putting together an approach to implement those solutions.

In conclusion, I hope to have shed more light on the insurance system’s ugly side of waste, fraud, and abuse. And also recondite. Going forward lets ask the right questions, with the right grace to get beyond our recondite, and work towards the solutions best for us all.