The latest part in what should be an award-winning New York Times series, “Being a Patient,” was published today. It begins to cover the financial aspects of the American healthcare system. The insurance companies, predictably, deny that any of the problem is their responsibility. In fact, Dr. Alan Sokolow, chief medical officer at New York’s Empire Blue Cross Blue Shield is quoted as saying, “even though the amount of paperwork a patient has to deal with might seem to be a lot, it would be much worse if there wasn’t a unifying organization like a health plan easing that burden.” Yeah, right. Insurance companies are responsible for the endless string of indecipherable explanation of benefit (EOB) forms that arrive regularly in patients’ mailboxes.
One of the biggest problems is that everyone from the healthcare providers to hospitals to the insurance companies use different and incompatible sets of keycodes, so it becomes an unsolvable puzzle to discover who did what when and where. It’s gotten so bad that some of the patients profiled by the Times have taken to hiring private social workers to help them manage the paper nightmare attached to illness. That’s inexcusable but nearly mandatory for all but the simplest, single-shot episodes with the healthcare industry in this country. In my own case, my wife spends more than 20 hours a week managing this part of my end-stage renal disease. That’s just wrong.
The best quote in the Times article came from a most unusual source, Dr. David Brailer, National Coordinator for Health Information Technology, in the Department of Health and Human Services:
“Suppose you walk into a restaurant,” he said, “and you don’t get a menu, you don’t get any choice of what food you’ll eat, they don’t tell you what it is when they’re serving it to you, they don’t tell you what it’s going to cost.”
“Then, weeks or months later, you get a bill that tells you all the food you ate and the drinks you had, some of which you remember and some you don’t, and although you get the bill, you still can’t figure out what you really owe.”