OK so my healthcare is in the hands of an HMO. All of us at my hospital (save the two owners) are offered this dubious benefit. Actually, I’m thankful; I might not have found affordable insurance for myself otherwise. But this healthcare plan truly adds stress to my life. Furthermore, it gives rise to murderous dreams involving [very stupid] claimspeople sitting in Aetna-blue damasked cubicles with telephone headsets indelibly attached to their skulls. If that’s not a nightmare I challenge you to come up with a better example.
I’m sure some of you have had similar feelings (excepting the vivid dream, perhaps). If not, I’m told by wise veterans of the healthcare system that all you need in order to acquire a solid understanding of the healthcare crisis is a nice scary case of breast cancer or a raging meningitis. Extreme illness as a surefire path to enlightenment…hmmm…joining a monastery seems so much simpler.
Recently I’ve had cause to reexamine my reliance on an HMO. It’s also made way for musings on the co-existing efficiencies and deficiencies of the current veterinary system of healthcare. Here’s my tale of woe and its subsequent analysis:
Even the simple health issues someone my age has to deal with are made hugely complex with the insertion of the three-letter acronym, HMO, on the almighty piece of plastic that determines whether you will receive care that day or not.
Over the past three weeks I’ve been to five doctors, two labs and two specialty service technicians. All this…and I’m a fundamentally healthy person!
This workup is considered fairly routine for a woman making her foray into the nearer shores of middle age. And to have it done right requires my insurance company to individually approve each part of the process…which means each individual healthcare provider has to fret over the minutiae of the referral process.
Instead of having one or two doctors take care of everything I’ve had to see five to comply with HMO referral policies. I’ve had to wait on hold for at least twenty minutes at a time each time I’m forced to call my insurance company for approvals. I’ve also had to stress about finding in-network labs and facilities, driving much further if I want the higher-quality versions of basic diagnostics (bloodwork, cytopathology, imaging, etc.). And, again, it can’t all be done under one or two roofs—it has to get spread out…to minimize efficiency, of course.
And the quality of service? The medicine gets a very good to excellent rating (only because I worked the system hard to access it). But the customer service? Decent to downright poor.
These front-desk people apparently have no notion of being in a service industry. I was even turned away once—rudely—due to a “schedule misunderstanding.” (I’d like to see that happen at a vet hospital—it’s never happened at mine.) Another time I was badgered (nastily) for my referral paperwork (by an office manager) and told the doctor could not see me without it—all because the receptionist had left it in the copier. No apologies.
Veterinary care might have far to go in providing the high level of human healthcare many of us can afford only through our current system. But the inefficiencies inherent in this system’s construction makes me wonder if building a vet version will prove any better. The layers of human lassitude that overlie the layers of bureaucratic, money-milking middlemen are enough to render the best of care unforgivingly stressful.
The cynic in me says the HMOs design their inefficiencies to weed out those unwilling to work hard to get care. It’s OK if they lose money paying out fees to all my superfluous doctors; the more plentiful, less avid seekers of healthcare will make up the difference in spades…by not getting any.
One of these days, I predict that my own industry will start to show its bureaucratic tendencies through more intrusive pet health insurance programs. If it helps a greater number of pets get better healthcare, who am I to stand in the way?
Somewhere between the evils of 100% managed care and straight fee-for-service lies a happy medium that works for us all. Maybe pet medicine will be the first in healthcare to finally build a system worth keeping. Or maybe not… What makes us think we can achieve the delicate balance that’s evaded human medicine for decades?
Maybe if we take out the big money and the politics behind the system, it can actually achieve some semblance of functionality. And guess what? That’s vet medicine for you: no big bucks and precious little politicking. Come to think of it, we might actually have a shot at success.
Regardless of what the future brings, my recent experiences managing the treacherous HMO waters have taught me [at least] one thing: I hope I never live to see the day when I’ll refuse care for a pet who walks in the door without a proper referral.
