I am finishing up some medical stuff, and in the last several weeks I have contracted a new illness, form-phobia.
Doctors, clinics, hospitals, insurance companies, and the federal government all want to know about me, my medical history, my parent’s history and, of course, who to call in the case of an emergency. Even though I am in the same system with all the providers (Shore Health), the level of redundancy is brain numbing. If you ask why you have to answer the same questions over and over, the answer varies between “don’t ask me” to “it is required.” It makes no sense to get mad at the person who is handling the paper; it makes sense to get mad at the multi-institutional inertia.
Most everybody knows that in the US we spend more per capita than any other nation that achieves similar health outcomes, in many cases significantly more. Plus, we all know that all manner of politician is promising us more health benefits, but few are suggesting we are actually going to have pay for them. And to add to the stress on our health systems, the Medicare trust fund is forecast to run out of money in 2026 while Medicaid spending is funded out of Federal and State general revenues and has been taking an increasing share.
We have a simple option. Pay more or spend less. We all know, of course, that spending less will run head-on into powerful lobbies that will fight until they have no pulse.
We all deal with industries that have been forced to modernize. In the late 1980s buying or selling a stock cost an average of $45. And then, well the Internet happened, online trading became popular and now companies that still make a profit charge a fraction of what they used to. One reason they are still making money is that they are using technology to achieve extraordinary efficiencies.
I use the financial industry illustratively because it too deals with information that must be protected. Health care providers must do the same. We do not want information about our health status to leak out, nor do we want inaccurate information to compromise treatment.
I realize there are institutional differences but let me provide an example of what can happen. I had a foot issue some time back and went to a doctor recommended by a friend at the Hospital for Special Surgery in New York. I completed one form online and then on each visit was asked whether there had been any changes. And, I dealt both with the Doctor and his professional and administrative staffs by email. Change is possible!
I know, drug companies charge us too much. And yes the costs of various procedures differ and sometimes by a wide margin from hospital to hospital. I am all in favor of taking on the big institutions and their lobbies, but why not bring the paperwork blizzard into the 21st century?
Al Sikes is the former Chair of the Federal Communications Commission under George H.W. Bush. Al recently published Culture Leads Leaders Follow published by Koehler Books.
Willard Engelskirchen says
One thing the author seems to overlook is that in the US all those forms are needed because whoever is going to pay whatever part of the cost is trying to find any way possible to avoid paying the bill. The only exception seems to be Medicare which is very efficient.
I do not like the forms either. A solution might be to FORCE all providers to use the same form or to make all forms compatible. But try that and see who screams.
But then we are only the customers. What importance should we have in the whole equation. The insurance companies act like they are paying – we are.