Sick’s Second Burden: Paperwork
Economists say that we respond to incentives–carrots and sticks. What’s it say about us as a nation, then, that people with serious illnesses consider stopping treatment under the constant onslaught of confusing paperwork? The New York Times writes today about the paperwork nightmare many hospitalized people return home to in Treated for Illness, Then Lost in Labyrinth of Bills.
I wonder again how long it will be until we wake up and realize what a waste of peoples’ time, energy, and effort these redundant bureaucracies are.
I had a similar experience on a much milder scale several months ago; I presented to the student health service with some unexplained bruising and petechiae (I personally think it’s a stress/psychosomatic thing, but who knows), and the ICD9 diagnosis code was, of course, billed as… bruising. (I imagine there’s probably a “Bruising, Non-Traumatic” variant that should have been checked, but it wasn’t.) Two months later, I got a statement, then a “mandatory claim form,” then a bill (all separate envelopes, arriving separately, costing $1.00 right there) stating that in order for my health service visit to be covered, I needed to explain my accident in order for my x-ray (??) to be covered.
I had *no* idea what they were talking about; I’ve never had an x-ray in my life. I somehow found a chunk of time during my surgery rotation, tracked down the date, and called the customer service representative. Then I spent 20 minutes enlightening her to my personal medical history, the fact that my bruising and petechiae were totally idiopathic, and that I never had an x-ray (her records indicated that I had had an x-ray and a fracture).
You left out perhaps the most important fact in the New York Times article: ” And to keep the system churning, close to 30 cents of every dollar spent on health care goes for administration, much of it spent generating bills and explanations of benefits.” If that alone isn’t enough to make single-payer compelling, I don’t know what is. I defy anyone who rants about “evil socialism” to go on television and, with a straight face, explain why a system that wastes so much of its resources creating, processing, and correcting such convoluted paperwork is better.