You know you're just pandering to your base when you use a phrase like:
"Obama is a master of that Clintonian tactic..."
Just a little gem while browsing through some conservative blogs. Has it really become so hard to find a decent conservative news outlet these days?
Wednesday, March 25, 2009
Monday, March 9, 2009
It's greed, it's incompetence 11:12 PM
I was recently reading a Chicago Tribune article from the column "what's your problem?" regarding a lung transplant recipient, insurance companies, and medication coverage. The gist of the story was that the transplant recipient was erroneously enrolled in a Medicare insurance plan as the result of his condition, so his actual insurer stopped paying for his medication. Thousands of dollars later and endless frustration lead to the patient's sister to write to a newspaper column to fix the problem. Within a week of the article, the problem was resolved no questions asked.
Many moons ago, I used to give the benefit of the doubt to employees, knowing that they can become overwhelmed with paperwork, phone calls, and requests that leads to sub-par performance. Though my empathy dried up after working in a customer service capacity for a year; it became apparent that the problem often is the result of laziness and incompetence rather than the burden of being overworked.
Everyone has a story about being hassled by a customer service rep and they're all similar. You call and ask if they received a fax, they say yes, you hang up. Months later you get a bill saying such and such documents were never sent and that you owe some ridiculous amount of money for this oversight.
This is when it gets painful.
You call and ask for the same rep that told you he/she got the faxes and they're either out of the office or no longer work for the company. No one can ever seem to locate anything you send over. Each time you call you talk to a new person. Managers fail to return calls. Then you get the distinct sense that you're being ignored.
Being on the customer service end, I was shocked to see phone messages ignored, faxes disappear, and paperwork hidden. Most of the time the employees were busy trying to figure out how to cut corners rather than plowing through their work. The worst came when employees would pretend to be someone else when talking on the phone to avoid overzealous customers.
Seriously? You bet.
I think the ramifications of this are far reaching. Our medical billing and insurance administration sizes have grown out of control. Things have gotten to be confusing and even require a degree just to understand it all. Unfortunately, because these jobs are often monotonous, they don't attract the sharpest tools in the shed. Then, bingo, you get the lung transplant patient that's paying through the nose for anti-rejection meds while customer service reps play keep away with his phone messages.
And this is the system that the "free market" has created for medicine. Somehow all medical decisions and payment decisions are routed through a high school grad wearing a headset too busy shopping online to answer the phone. With the click of a button they deny the needy money for medical procedures and medication all because follow up would cut into their lunch hour. And you would think that this behavior would be discouraged by the company execs, but it's not. The reason why is simple, it pads their bottom line. Every denied claim nets them cash, and the longer the claims are held up, the harder it becomes for the patient to recoup old costs. We've set up a system that rewards insurance companies for this behavior.
So with all the talk about fixing our healthcare system, why isn't this a bigger issue? These people are actually putting people's lives at risk by failing to make good on a promise made when they became an insurer. Shouldn't this be criminal? The fact that someone, anyone would have to write to a newspaper to solve a healthcare problem boggles the mind. The fact that legal action wasn't taken is even more mind blowing. After all, lawyers are always looking for another solid revenue source, why not go after the insurers? There have to be millions that could be made over these kinds of claims.
Why not? I don't know. Maybe someday we'll get wise, and hopefully it's before the day we need to rely on our insurance to save us.
Many moons ago, I used to give the benefit of the doubt to employees, knowing that they can become overwhelmed with paperwork, phone calls, and requests that leads to sub-par performance. Though my empathy dried up after working in a customer service capacity for a year; it became apparent that the problem often is the result of laziness and incompetence rather than the burden of being overworked.
Everyone has a story about being hassled by a customer service rep and they're all similar. You call and ask if they received a fax, they say yes, you hang up. Months later you get a bill saying such and such documents were never sent and that you owe some ridiculous amount of money for this oversight.
This is when it gets painful.
You call and ask for the same rep that told you he/she got the faxes and they're either out of the office or no longer work for the company. No one can ever seem to locate anything you send over. Each time you call you talk to a new person. Managers fail to return calls. Then you get the distinct sense that you're being ignored.
Being on the customer service end, I was shocked to see phone messages ignored, faxes disappear, and paperwork hidden. Most of the time the employees were busy trying to figure out how to cut corners rather than plowing through their work. The worst came when employees would pretend to be someone else when talking on the phone to avoid overzealous customers.
Seriously? You bet.
I think the ramifications of this are far reaching. Our medical billing and insurance administration sizes have grown out of control. Things have gotten to be confusing and even require a degree just to understand it all. Unfortunately, because these jobs are often monotonous, they don't attract the sharpest tools in the shed. Then, bingo, you get the lung transplant patient that's paying through the nose for anti-rejection meds while customer service reps play keep away with his phone messages.
And this is the system that the "free market" has created for medicine. Somehow all medical decisions and payment decisions are routed through a high school grad wearing a headset too busy shopping online to answer the phone. With the click of a button they deny the needy money for medical procedures and medication all because follow up would cut into their lunch hour. And you would think that this behavior would be discouraged by the company execs, but it's not. The reason why is simple, it pads their bottom line. Every denied claim nets them cash, and the longer the claims are held up, the harder it becomes for the patient to recoup old costs. We've set up a system that rewards insurance companies for this behavior.
So with all the talk about fixing our healthcare system, why isn't this a bigger issue? These people are actually putting people's lives at risk by failing to make good on a promise made when they became an insurer. Shouldn't this be criminal? The fact that someone, anyone would have to write to a newspaper to solve a healthcare problem boggles the mind. The fact that legal action wasn't taken is even more mind blowing. After all, lawyers are always looking for another solid revenue source, why not go after the insurers? There have to be millions that could be made over these kinds of claims.
Why not? I don't know. Maybe someday we'll get wise, and hopefully it's before the day we need to rely on our insurance to save us.
