Insurance Companies vs Physicians: Who's on first?

Does anyone remember the Abbott & Costello routine about "Who's on first"?  There was quite a bit of confusion since Costello didn't realize that "Who" was the name of the first baseman, and not a pronoun used to describe an unknown person. 

I bring this up because I stumbled upon a New York Times article about the insurance maze physicians have to deal with here in the States.  It turns out that a recent study published in the journal Health Affairs documented a four fold variance in the cost of dealing with insurance in Canada ($22K/physician/year) versus here in the States ($83K/physician/year) and a ten fold differential in terms of time spent (<2 staff-hours/wk in Canada vs 21 staff-hours/wk in the US).

Granted many of us are not thrilled with the idea of a single payer system as exists in Canada, the United Kingdom, and elsewhere.  We don't want the long interminable waits for tests & procedures that are accepted as routine by our neighbors to the north.  And who hasn't heard of some Canadian with means who crossed the border to get some test or procedure done sooner than if s/he'd waited patiently in line.  

On the other hand, the idea of healthcare as a right and not a privilege has a nice ring to it.  Of course, I'm not about to offer free plastic surgery and Botox(R) to everyone.  After all, remember that phrase about inexpensive, great and quick healthcare?  Well, it turns out you can only have two out of the three - but at least it's your choice as to which two you want.

Admittedly, I'm not smart enough to have the answer to a policy conundrum that has stumped our brightest minds for years.  However, given the number of insurance companies and their almost infinite plans/products, each with its own rules & regulations, it seems to me (and others) that convincing the insurers to play by the same rule book would simplify matters dramatically, and in doing so, decrease wasted & bloated expenditures to the tune of $27B per year.  

I'm not saying that the various insurers can't offer different plans/products but rather suggesting that they shouldn't make it so difficult to seek reimbursement that we have to hire coding & billing specialists such as Don Self.  Read the NY Times article and consider all the hoops we have to jump through each & every day.  And if we don't dot an I or cross a T, the insurer denies/withholds reimbursement for work we've already completed, often for months at a time.  Now you understand why some physicians (myself included) have (re)turned to a direct pay model and no longer accept insurance.