Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

Sunday, August 5, 2012

The cost of losing the human touch.

People aren’t perfect. Nor are machines. And that’s true, whether they operate in the public or private sector, despite all the politically charged criticism of government employees.

Perhaps you heard about this week’s technical glitch with automated trading at Knight Capital Group Inc. It rocked pricing on 140 stocks, with millions of shares trading hands in minutes, grossly exaggerating the volume and further shaking investor confidence in Wall Street.

Here’s another true story to add some real world perspective to my position about our era of errors.

Last week, I thumbed through the mail to discover a bill for $443.10 from a hospital emergency room for medical services, pharmacy and laboratory. I had been to that facility in Detroit’s northwest suburbs only once, some 20 years ago. The U.S. Postal Service is much more efficient and reliable than that, so, I called the 800 number on the invoice to deny the health system’s charge for services un-rendered. An automated system responded. It offered me several prompts and then a recording announced Customer Service was now closed and was available Monday through Friday from 8 a.m. to 4 p.m. I Googled the hospital’s main phone line and after a few touch tone strokes on my keypad, reached a human being who informed me that Customer Service was indeed closed.

“Those aren’t very convenient hours,” I said. “I’d like to take care of this quickly, since I did not receive any service from your emergency room.”

“They’re an outside agency,” the hospital operator responded. “You can leave them a voice mail.”

She connected me to the recorder. It was Friday about 4:30 p.m.

Monday morning, I called again and after navigating several prompts reached a human, Nora. When I informed her the emergency room bill was invalid, because I wasn’t at the hospital on July 16, 2012 or any other recent date, she asked for my account number. Then, to verify I was the legal party associated with the account, Nora asked, “What’s your address?”

When I answered, she said, “That's not the address listed on the account.”

“Please give me the address listed,” I requested.

“I can’t do that,” she said, “since this obviously is not you.”

“But what if the police would like to pursue that address?” I asked.

“Then they can call and ask for it,” Nora said.”

Fair enough. No need for vigilante justice here.

“But maybe someone has stolen my identity and is using my name,” I suggested. “The bill says ‘uninsured’, and I definitely have health insurance.”

“You should file a police report,” Nora said. “But I will need you to send us a letter declaring you were not in our emergency room and you’re denying payment.”

“Why do I have to do that work?” I asked. “You sent me an erroneous bill out of the blue, and now I have to write a legal document and mail it to you. You’re just trying to push your administrative costs on me.”

“It’s the only way we can compare your signature with the one on the patient chart,” Nora explained.

“Silly, Nora,” I thought. If I were a deadbeat,  I could simply alter my signature or have someone else sign the letter for me? Not a very reliable validation method.  And truthfully, I was hesitant about giving my signature to an organization that had sent me a bogus bill.

“Don’t they check ID at the hospital when patients are admitted,” I asked.

“They do,” Nora responded.  “You should also look at your credit report, in case someone has stolen your identity,” she suggested.

Frustrated with her analysis, I requested her phone extension and told her I’d file the police report.

When I dialed the Dearborn Police Department, after a list of automated options, I selected one that allowed me to speak to a police officer. He listened to my story and then quickly offered to send a car to our home for me to file a report. It was 9:45 a.m. on Monday.

“I have an 11 a.m. phone conference,” I said.

“There’s a car in the area. It can be there in the next 10 or 15 minutes,” the officer responded.

“Great,” I said and gave him my address.

Within 15 minutes, two professional Dearborn Police officers arrived, Corporal Tapping and Officer Burns. I invited them in and quickly walked them through my story.

“You probably should do a credit report check,” Corporal Tapping said.

“You’re entitled to do that once a year without affecting your credit rating,” added Officer Burns.

I had provided them with a copy of the invoice as well as Nora’s name and extension.

“This is the first billing,” noted the corporal. “Rather than you writing them a letter, we’ll call them and find out what’s going on.”

Before leaving, Officer Burns wrote down my police report number, her name and her partner’s and tore the sheet from her pad. She took my phone numbers and promised to get back to me. It was about 10:20 a.m. I told them I had an 11 a.m. phone conference so they might get voice mail.

After walking the officers out onto the front porch and saying thank you, I immediately checked my credit report online. Fortunately, there was no sign of foul play.

By 10:40, Corporal Tapping was calling back. “We reached the hospital and it seems like someone with a very similar name as yours was indeed in the ER on July 16,” she explained.

Turns out only one letter separated our last names. We also had the same first names, but he was more than 25 years younger. Too bad the hospital didn't pause to match birth dates when issuing the bill.

“Well that explains it,” I said. Must have been a keystroking error, I surmised. The electronic billing system automatically pulled up my address.

I told the corporal my credit report check was clean.  She promised to call again to let me know about the need to write a follow-up letter to the hospital.

“You might get my voice mail,” I warned. “Feel free to leave me a message, and thanks very much.”

I was already feeling better and got ready for my phone conference.

10:59 a.m. Dearborn’s finest was on the phone again.

“I talked to the hospital. They said there’s no need to write them a letter,” said the corporal. “If you receive another bill, simply call and give them your police report number.”

“Thank you so much,” I said.

Then I dialed into my phone conference with peace of mind, and gratitude that I have such a responsive city government.

My identity hadn’t been stolen. There was no unpaid bill for hundreds of dollars, just a clerical error someone made when they relied on automation, the way a novice might trust Microsoft’s spell-check feature. The private healthcare corporation got free investigative services, complete with a house call, courtesy of the local government. And the hospital wasted at least an hour of my time.

We live in a technology-obsessed world. This weekend, I saw a self-serve key-cutting machine at the big box hardware store. There were also multiple self-serve checkouts, way more than those with clerks. Much of this is sold as convenience. In reality, it’s designed to replace people with machines. Machines that customers operate. We run the switchboard when we call. We book our own flights and hotels, schlep our own luggage, pump our own gas, and, if we don’t want to wait, check and bag our own groceries.

And it’s all getting cheaper, right? Especially healthcare.

I love technology when it’s used properly, as a tool. In “The Jetsons” cartoon, “Rosie” the robotic maid was always so friendly. But, in real life, machines are only as good as the people who make and control them. Thank goodness the Dearborn cops I called weren’t androids.

By the way, neither Nora, nor anyone else from the hospital called me back to apologize.

There’s no profit in that — in the short run.



Sunday, July 1, 2012

Rising tides of laziness


Last week, National Geographic News reported that the Atlantic Ocean was rising on the east coast of the United States, approximately three to four times faster than other areas in the world. Consequently, Boston, New York City, Philadelphia and Baltimore could experience more frequent future flooding. Instead of floodwaters occurring every three to four years, they are likely to hit these urban centers three to four times annually.

Don’t panic. The real high tides won’t rise until the year 2100. But if you care about your grandkids and their children, then this might be reason to take notice and action.

What really got my attention was a report this week that the big boss at ExxonMobil, Rex Tillerson, is now acknowledging climate change. Wow! So, global warming is no longer flawed science? What triggered the shift in company opinion? Maybe it’s the triple digit temperatures from sea to shining sea, the raging forest fires in Colorado and the mega storm that depowered several east coasts states and Washington, D.C., leaving two million Americans in the dark this weekend.

The oil company’s CEO went on to declare that instead of trying to prevent the higher temperature trend, we should begin investing in ways that will allow us to adapt to a planet that’s growing too hot for humans. “It’s an engineering problem,” he said. In other words, keep consuming fossil fuels at record rates and turn up the AC or some super solar shield that enables us to keep things just as they are. Spoken like a guy who makes his living selling energy. Why bother inventing groundbreaking alternative energy technologies when you can subsidize the fossil fuel industry and secure the status quo? The ExxonMobil chief also said the impact of climate change is being exaggerated.

Although I don’t agree with Tillerson’s analysis, he did say something that I support at some level. He blamed our misunderstanding of climate science on a “lazy” press. He believes our failure to grasp climate change issues is due to journalists who simply accept and reprint environmental rhetoric.

In my opinion, Tillerson is half right. It’s not that tree huggers are on the wrong side of the issue, but it’s the failure of the researchers, reporters and editors to dig and independently develop the story and guide readers and viewers to genuinely validated and transparent information.  And many consumers have refused to explore and educate themselves, as well. We tend to accept what we’re fed, which is generally a sensationalized screaming match about hot topics producing all heat and no light.

Case in point. When we have a severe cold snap or blizzard, the pro-business lobby mocks the global warming crowd, as if an ice storm means that NASA scientists are quacks. After all, before it was global warming it was global cooling, right? The reality is that our climate is definitely changing. And even if we can’t control it by altering our behavior, I can’t imagine that the average citizen would fight for more pollution. Unless, of course, their livelihood depended on spewing more crud into the air or turning a blind eye to dumping toxic wastes.

Our professional media, the fourth estate, is a necessary filter between the public and propaganda artists. Without vetting, how do you know who to believe or trust? However, you are on firm ground if you doubt media sources for a number of reasons. For example, today, local television stations routinely produce programs for sponsors and pass them off as quasi-documentaries or feature reporting. In reality, they are nothing more than paid infomercials. In the old days, late-night TV junkies might watch a presentation about a new kitchen gadget at 2 a.m. Sunday. It was obvious the manufacturer bought the time. Today, you can see a primetime special about technology at a local hospital, bought and paid for by the healthcare institution, and produced by the station’s news crew. The lines between journalism and marketing have become so faded, you have to ask, is the press dead? No questions about the impact of the technology on healthcare costs; the proven, long-term effectiveness of the therapy or the tradeoffs. Of course not. You don’t do that with marketing, even when it’s disguised as reporting.

During this week’s wall-to-wall coverage of the Supreme Court’s healthcare ruling, one interviewer on Bloomberg News was surprised to learn that hospitals lose 20 to 30 percent of their billings, because uninsured patients fail to pay. How could any competent journalist or literate American not know by now that healthcare providers routinely eat a steady diet of unpaid bills?

Today, about six large corporations control some 80 percent of the U.S. distribution of news. Some 50 companies once shared that business. Visit the Web sites for Disney, NBC Universal, News Corp and Viacom, and see how much media each of those giants own. Unparalleled consolidation has occurred.  Our perspective has narrowed significantly and there are far fewer voices with access to booming amplification. They sing from the same song sheet. The rest of us tweet.

For example, the last time an independent political candidate made a significant impact on a national election was 1992. That’s twenty years ago, before the consolidation that has chilled alternative perspectives.

Meanwhile, it surprised me how little I heard about ExxonMobil’s climate change admission. But then again, all that matters now is healthcare. A major energy company admitting fossil fuels contribute to rising temperatures is a little bit like big tobacco finally acknowledging smoking kills. Yet, where’s the coverage?

So, what have you decided? Is the trend toward ultra dry, hot weather just a blip in Mother Nature’s hormonal cycle or is it a sign of things to come that we should address? In this age of endless information and hundreds of sources do you know where to go to learn?

Big oil says climate change is real, but don’t sweat it. Personally, I'm glad I live in the Great Lakes State.