May 12, 2010

“This is what your healthcare is going to look like”

BY Dr. Keith J. Kaplan

Last month I was in a post office standing in a particularly long line for that location.  The line eventually extended beyond the lobby and outside the doors.  The delay seemed to stem from the fact that this was between 12 and 1 PM when there were several customers and only 1 staff member during a busy day and time.  The situation was made worse by the fact that the staff person was trying to assist an elderly customer who was asking for an unusual denomination for a particular stamp to go to a particular place somewhere in the world.  And she wanted to write a check and appeared to have a terrible tremor which made writing clearly difficult.  Plus you have to retrieve and show valid photo ID when presenting the check to the post office. 

These things happen.  It was going to cost me an extra 10-15 minutes. 

An equally elderly customer about 5 people behind me yelled out "This is what your healthcare is going to look like". 

I disagree.  We can only hope healthcare reform allows for what I consider a normally efficient service.

For some of the shortcomings of the US mail, with its rigid policies and procedures I can count on 1 finger the number of times an intended delivery or sent item was not received over several decades of using the US mail for pen pals, college applications, med school applications, licensing forms and business transactions.  Of course, e-mail and other electronic services have minimized the necessity for traditional "snail mail" services which has affected the bottom line for the quasi-governmental organization. I find the need for delivery confirmation or certified letters to be negligible given the time and accuracy of mail delivery.

Let's assume some components of the healthcare reform do look governmental or quasi-governmental if you don't have "private insurance".  Having worked and received care in military, VA and large academic institutions, my experience is that quality overall is the same, the speed (meaning wait time from definitive diagnosis to definitive care/management) varies greatly with access issues and beaurocratic inefficiencies sometimes causing delay between getting seen and getting treated.  While commerical hospitals are not immune from their own inefficiencies, generally access is simplified and referrals are timely. 

So, while your health and your mail are not the same, if 42 cents buys you 2-3 day delivery at the expense of a few minutes to get it going, perhaps cost can be controlled with quality outcomes with reasonable wait to get the necessary service particularly for those who would not normally be afforded these services or for whom alternatives are not available. 

Would it be so bad if healthcare ran like the post office? 

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