My wife had surgery yesterday. The surgery went well and we are pleased with the medical care she received and thankful we have medical insurance that will pay the costs for the procedure and time at the hospital.
We were both surprised by the amount of redundancy built into the system. Before the surgeon met with her and she was wheeled off for surgery, seven different people met with her. Many asked the same questions, dutifully recording what they were told, and initialing off on their work. Just as in the airplanes I fly, for procedures affecting physical well being, I want redundancy. The catch is, I want redundancy that serves a purpose and applies to critical systems. We observed that did not appear to be the case yesterday. Instead of reducing the likelihood of error, the system is likely to increase it duplicative inputs and not having a common data repository. Human error happens. When the results of the error can be serious, such as in an airplane's system or a surgery, then steps should be taken to reduce the probability of the error or its seriousness. By so many people asking, and separately recording, my wife's allergies, for instance, it makes more sense to me to have the parties that need to know (e.g., the anesthesiologist) to confirm what the intake nurse already recorded. Every time more than one person inputs what is to be the same data into a system, and one that should be commonly accessed, the likelihood of error increases, not decreases. It is my understanding the reason each person is asking duplicative questions and submitting duplicative answers is because, well, a giant system of covering your ass. Why is that needed? I maintain it is primarily for legal protection, to minimize the liability if an error occurs. The fact that it is more likely to occur is irrelevant, because it can be targeted to a smaller cause, but all individuals and institutions involved then have to carry inordinate malpractice insurance, just in case. Costs go up, but because of my good insurance is going to be paid for, no one seems to care, yet everyone seems to be shocked by the continually rising cost of health care. (Health care is one of the two major components outpacing general inflation; the other being education. Interestingly, both areas are highly unionized and either highly regulated or administered by the government.)
In the last half year, I have undergone extensive and expensive medical tests. Beforehand my neurologist correctly told me what the results would be. The tests were conducted not because he thought they were necessary, but to rule out a couple of remote possibilities of what could be contributing to my symptoms. At most, the likelihood of my having either condition was estimated at less than two percent. If it had been up to my neurologist, he would have taken the safe bet the two percent chance of one of those conditions was not present and treated me accordingly. Instead he ordered the tests. Why? To cover his ass. Interestingly, my insurance provider did not disagree with the treatments - they need to cover their ass, too - but they did argue over where the tests should be performed. I suspect the difference in costs between the two sites was more than offset by the time spent arguing over where the procedures should be done. That said, I am talking about my life here and if there is a two percent chance that there is a treatable condition that left unchecked could be fatal, then I want it checked. If the two percent was you instead of me, I would feel at least the same way. My situation was never presented as the remote, fatal if not checked chance. though, so, despite the tribulations I have experienced over the years to get to the root cause of my symptoms, I would have said no. The tests were done. Costs were incurred, resources redirected, all because of the possibility I could become a plaintiff.
The American people voted for change in the election of Mr. Obama. He has made health insurance change a keystone of his presidency. Transparency, inclusion, and evaluation of options were promised. I do not know the answers to the issues of health care costs and coverage, but an obvious component is tort reform. This is a component missing from the legislation, for apparently old school politics reasons - litigators are major campaign contributors. From my vantage point, the only thing transparent about the change in Washington is heightened Tammany Hall politics.
No comments:
Post a Comment