I return to work today after a week recovering from a major procedure. I underwent gastric bypass surgery to treat, among other things, my adult onset type 2 diabetes.
While no surgery occurs without pain, discomfort, disorientation, and some period of recovery, I can say that my experience has been as good as it could have been given the circumstances. My doctors, their staff, the insurance company, and the healthcare provider have all performed professionally and effectively.
That said, as a guy daily occupied with the effect of government upon the human experience, I certainly perceived areas where the healthcare system would undoubtedly improve if less encumbered by government. First, I noted inefficient compartmentalization.
To give you an idea of what I mean, consider the path taken to get this surgery done. First, I needed to see my primary care physician for a referral. Then I needed a consult at a weight loss clinic. Then I spent three months checking off a long list of labs, dietitian visits, psychological evaluation, and preparatory classes and consults. Despite the fact that nearly all this occurred under the umbrella of the same healthcare provider, every single time I saw a different person – even within the same clinic, it was like I was being seen for the very first time. I had to answer the same questions, fill out the same forms, tell the same story, over and over again. I can only imagine how frustrating this is for patients dealing with chronic illness.
To a certain extent, this redundancy can be justified. Some of it no doubt serves patient privacy and security. For instance, asking for my birthdate or address could be a verification check to ensure I am the right patient. However, I have a hard time believing that explains most of the redundancy. Most of it seems to be a product of compartmentalization, a lack of access to information previously disclosed. Other industries model customer service solutions which could easily be applied to healthcare.
When you go to the airport in any major city, you can check in at a kiosk and get your boarding pass without seeing a clerk. You can even check in online ahead of time, from your phone while in transit if necessary. Why can’t we do this in healthcare? I get to an appointment on time, but have to wait ten minutes in line behind other patients with more complex needs, and end up checked in late. There’s no need for that.
When you take your vehicle into a quick lube joint, the mechanic scans your vehicle identification number and summons a complete maintenance history and manufacturer-recommended services. Why can’t we have a card in our wallet with our medical data encrypted on it? We could control who sees what and under what circumstances. We’d never have to fill out a questionnaire again, just keep the history updated. Why hasn’t this happened?
Such innovations require an environment where nimble and risky moves are allowed and, when successful, rewarded. In short, they require a free market. We don’t have that in healthcare.
Note that the full effect of Obamacare hasn’t even been felt yet. What we’re dealing with today is largely the same system that existed before Obamacare’s passage. Too often, we fail to recognize that the American healthcare system before Obamacare was hardly ideal. In an effort to “protect” people from their own judgment, the system has long lumbered under the weight of intrusive regulation, retarding progress.
The rights of individuals, whether patients, doctors, staff, medical device manufacturers, and – yes – even insurance company stockholders, should be the driving force that shapes the healthcare market. Until it is, we will continue to run at far less than peak efficiency and fail to reach the full potential which would be unleashed under the condition of liberty.
(Today’s Fightin Words podcast is on this topic available here.)