Why Is Health Care So Fucked Up?

April 21, 2006 @ 12:36 pm

The American health care system is fucked up. And I’m not talking about health care on the macroeconomic/social policy scale here — right now I’m more concerned with the average Joe/Jane’s trip to the family practitioner or the emergency room.

• Why do so many doctors still schedule appointments in a black ledger book on the desk instead of in a shared calendar on the computer?
• How come they can’t e-mail you to confirm or reschedule your appointment?
• Why is it that every time you go to a new doctor or hospital, you have to fill out that same damn patient information form on a clipboard in the waiting room and wait for someone to type it in to the computer?
• Why do they actually need to photocopy your health insurance card?
• Why is that the doctors all scribble notes on pads of paper that can easily be lost or damaged (or misinterpreted) instead of using a PDA or a tablet PC?
• Why do you get handwritten prescription slips that you have to physically shepherd over to a pharmacy in your car?
• Why do you have to wait another week or two for the cryptic paper statement to arrive in the mail from my insurance company?
• Why do supplementary bills come trickling in from various medical labs a couple of weeks after that?
• Why are there constantly mistakes in the billing that need to be corrected with a million phone calls and faxes?

It’s simple: American health care practitioners haven’t caught on to information technology. It’s an industry that’s stuck in the Stone Age.

I’m not saying that your doctor’s office shouldn’t be conservative. Obviously when lives are on the line, you don’t want to be experimenting with the latest techno-fad simply for the sake of being on the cutting edge. The last thing you want during an emergency is to have all of your PCs taken over by some Russian hacker’s spambot.

And of course, let’s not forget that health care practitioners have to maintain a higher standard in terms of privacy and accountability. It would be very easy for the government to build a national database of health information that holds a record of all your allergies and illnesses — but very difficult to actually secure that information against hackers, nosy employers, religious zealots, thieves, etc.

Still, these are excuses. If your local hospital and family doctor believe that they’re immune to the competitive pressures of the marketplace, they’re gravely mistaken.

Most private-sector businesses have learned that a simple rule: either adapt to new technology or die. That’s why when I go to Jiffy Lube to get my oil changed, the folks behind the counter know who I am before I’ve even gotten out of my car. If I go to any Starbucks or Borders or Harris Teeter, I can whip out my loyalty card and get instantly recognized. (Granted, I’m not claiming that Borders gives a damn about my privacy or would hesitate to sell information about my purchasing trends to a third party. But Americans are starting to catch on to the whole privacy issue, and I think a sea change is coming in the next decade.)

So who’s going to drive these Luddite small practitioners out of business? The big pharmaceutical companies, of course, who would rather sell you their products directly over the counter at CVS instead of through an unreliable agent like your doctor.

Want to know if you’ve got pneumonia or herpes or acid reflux disease? No appointments or primary care physician referral required — just pick up the do-it-yourself testing kit at the local pharmacy. Having trouble interpreting the results? Visit the website and talk about your symptoms in an online forum. Unsure of what to do next? Discuss your case with a doctor from India or Japan via teleconference. Need antibiotics? Merck will Fed Ex them right to your door.

Sound expensive? Not really, when you consider the hours you’ve saved dealing with red-taped doctors and pharmacies — and when you factor in the monthly savings of cutting your health care plan to the bone. Who really needs doctors anyway for most of our day-to-day illnesses? Why not just hire a health care broker or independent medical consultant to do all this legwork for you?

Accountability? No, I’m sorry, we’re just an independent health advisor, we’re not doctors. Didn’t you read the disclaimer on the website before you confirmed your purchase?

I can see certain advantages to a system like this, but DIY healthcare would just put more strings in the hands of the pharmaceutical companies that sell you these products. And we all know that pharmaceutical companies rank right up there on the ethical scale with oil companies, government lobbyists, and that guy in Nigeria who keeps asking me for financial assistance for my long-lost relatives.

But if your family doctor can’t learn to adapt, I’m sorry to say that he’s headed for the endangered species list.