What Healthcare System?

There is no healthcare system in America.

Yes, we do have great doctors, nurses, hospitals, clinics, EMT, pharmacists, and healthcare professionals/paraprofessionals of all stripes. Their hearts are good and their efforts are heroic. They can be incredibly effective. They could be even more effective if we actually had a system for providing healthcare. 

What I mean is that the various pieces do not operate as a system. Every time you have a hand-off of a patient from one doctor’s office to another, you risk some sort of glitch.

At the very least, patients referred to a different doctor’s office must fill out paperwork before seeing anyone — paperwork redundant to the paperwork just filled out in the referring doctor’s office. Somehow, it seems I shouldn’t have to keep rewriting that same information for every medical office.

Certainly, it makes sense to see a specialist when needed. No one doctor or clinic or hospital can provide all the healthcare you need. Healthcare organizations claim “continuity of care” to suggest they offer a smooth transition to other providers of various needed services. The reality falls short of the promise.

As a recent example, I experienced unexpected problems in getting a refill for my insulin, due to a national shortage of the specific brand I’ve used for 10 years. While the pharmacy was able to substitute a different. brand (after contacting my doctor’s office), I wish I had known in advance that would be necessary. The manufacturers knew there was a shortage. The FDA knew there was a shortage. The pharmacy knew there was a shortage. But I only found when I tried to refill that particular prescription. It seems like someone should have warned me about this delay.

That was bothersome enough, but just a week later, I needed a refill order for the needle points needed for the insulin injections. When I went to pick it up, they had a prescription ready for me — but it was the wrong prescription. They offered me pre-filled insulin needles, not the needle points I need to use my insulin.

They were able to quickly straighten that out, but when they rang up the purchase through my insurance, the cost ran over a hundred dollars. As a straight-up cash purchase, however, the same needle points only cost me $27.

Someone explain that to me.

I certainly do not have any suggested solutions. Nor do I have any real complaints about any healthcare providers involved in my rehab from last summer’s injury—they have all been great. Even so, there were multiple minor issues working my way through the so-called “system,” especially whenever I was referred to a new practitioner.

Unfortunately, the disjuncture between the various moving parts produces inefficiency. This presents an economic opportunity for those who want to exploit it. And exploit if they do. That’s why I say we don’t have a healthcare system in America, we have a health insurance system. And that system, as our longtime Austin doctor used to remind me often, is “uniquely designed to suck money directly out of your wallet.”

As I said before, I do not have a suggested solution. But somehow, over 30 other countries do offer some form of universal healthcare. There are multiple models we could study and emulate.

We can do better.