Health Care Red Tape

October 19th, 2009

health-red-tapeIt’s a term directed derisively at government bureaucracy, often accompanied by copious cursing. But something’s happened with health care as administered by private insurance companies that can only be described as [expletive deleted] red tape. Here’s a recent example that’s astounding, given the rip-roaring national debate as to whether private insurers or government can provide the best service at the best cost.

I went to switch dentists, since I’ve moved to a different area than where I was living. First I had to search my HMO’s web site to find a dental office that accepts my insurance plan and accepts new patients. I called an office nearby and was informed that I need to get a new insurance card from my insurance company listing this dentist’s code number. OK. I called an 800 number on my old card and encountered a pre-recorded voice asking me why I was calling. The choices offered by the pre-recorded voice did not include changing dentists. I was instructed to start over and explain why I was calling. I said again, “I want to change dentists.” “OK, you want to change dentists,” the pre-recorded voice said this time. “You need to speak with a service representative.”

Ultimately, a live person gets on the phone. He asks for my ID number and date of birth. Sorry, he says, that’s the wrong date of birth. This was news to me. I’ve been enrolled with this same insurance company for years. I state again that this is indeed my date of birth. He asks for my social security number. That turns out to be acceptable. But there’s still a problem with the recorded date of birth, he says. It could cause problems in paying bills from the new dentist. And his company can’t correct the information it has on record, he adds. That has to be done by the company I retired from.

OK, I rummage around and find a phone number for the human relations office of the company I retired from. I call the number and get a pre-recorded voice that says there’s a new number. I call that number, and the pre-recorded voice says there is a newer number. I call that number and leave a message. Someone calls back and says there was indeed a typo on a document that was sent to the insurance company and it will be corrected.

Back on the phone with the insurance company guy. He says, once they hear from the company I retired from about fixing my date of birth, they’ll mail a new card with the new dentist’s code number on it. The new card, he adds, will be effective next month.

Meanwhile, I rummage through piles of advertising stuff from insurance companies, slick brochures from politicians weighing in on the national health debate, and other mail. There’s a form letter from my health insurance company. It informs me that the COBRA extension of my former company’s dental plan expires in two months. It provides no information on what my choices are in getting dental coverage after December 31. There’s also a bill for next month’s payment, which includes a fine print warning that my policy will be cut off if I’m late in making that payment.

So now I’ve got to check out Medicare, which I joined when I retired last year, and see if the government can tell me how to go about getting to see a dentist.

(This article was also posted at EarthAirWater.)

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10 Responses to “Health Care Red Tape”

  1. Harvey |

    That’s a real horror story Jan but this wasn’t the Insurance company’s fault. Actually your problem was generated by the company you worked for when they messed up your DOB. If they had gotten it right, the only problem you would have had was getting through those damn automated telephone systems.

    You’re dead right about bureaucracies though. Every big company has a big bureaucracy — the bigger the company the bigger the bureaucracy. Insurance companies do have problems caused by their size and do cause problems for their customers but their problems are small potatoes (as you probably know) compared to navigating the Federal bureaucracy.

  2. Jan |

    Harvey, Maybe I didn’t make the point clearly enough: The HMO I paid into for years is dumping me. I’ve actually had a much better experience with Medicare, but that’s another story.

  3. Brian Bagent |

    Jan, you’re not getting dumped. COBRA expires after 18 months. If you weren’t MediCare eligible, I’d suggest checking out MEGA or Midwest National Life of Tennessee, both of whom are generally less expensive than paying for COBRA and provide outstanding coverage. The last time I looked, the only state where you could not get individual coverage health insurance was New Jersey.

  4. Tom |

    I certainly sympathize with the red tape issue. But in my experience, it’s a fact of life when dealing with any large bureaucracy, whether commercial or government. I just wrote about my struggle with United Airlines, trying to get through their voice recognition, button pushing, endless menus to talk to a human being. But I’ve had the same experience with numerous government agencies, too.

    Given that we’ll probably never escape red tape, I guess I’d rather deal with businesses than with the government where my personal affairs are concerned. At least where businesses are involved, I can always go elsewhere. Well, maybe always. Some of the time, anyway.

  5. Brianna |

    I would also note that industry has a vested interest in becoming better at their jobs and reducing the amount of red tape, because they need to make a profit to stay in business (provided of course, the government doesn’t hand them bailout money) and there is always the threat that someone else can do their job better than they can and put them out of business. Government doesn’t need to worry about competition or making a profit, because they can always fall back on the US taxpayer to cover the cost of their bureaucratic red tape and general incompetence.

  6. Jan |

    Well, folks, the fact is I’ll soon be in the fix that many Americans are in. If not for COBRA, a federal law, my dental plan would have ended as soon as I retired. If not for Medicare, a federal program, I’d have no health coverage as well. When I was growing up in the long ago, private insurance companies didn’t exist. From a number of experiences I’ve had with these companies, they are not consumer-friendly. No doubt they’ll soon be looking for bail out money, too.

  7. Brian Bagent |

    Jan, if not for government interferance in the market, it is very unlikely that you’d need any sort of health insurance save for the catastrophic. It is government meddling that has caused, and continues to cause, the falsely elevated market that currently exists.

  8. Tom |

    Since I’m about the same age as Jan (one of us is a few weeks younger, but I won’t say which), I also remember when people didn’t expect to have health insurance. We went to the doctor or hospital, and we paid the bill. Some people had insurance for catastrophic stuff, but certainly not everyone. Those may or may not have been the good old days, but it’s too late to go back.

    I think almost the whole country would agree that costs are too high and that everyone should have access (and not through the ER). A simple health care bill that addressed just those issues and not a liberal wishlist of social changes, plus a gazillion earmarks for favored contributors, would probably pass easily.

  9. Jan |

    There’s a good article in the current Time magazine, “A Healthier Way to Pay Doctors,” that describes some sensible changes some local hospital/health care systems have made. The government didn’t make them do it one way or another. They just decided to do things in a more sensible way and bring down costs while providing better services. As for dentists, I may go back to just ignoring them, like my father did–until almost all of his teeth had to be pulled out.

  10. Brian Bagent |

    Jan, I have no problem with a private entity deciding to change the way it does business. If it works and provides better service at a lower price, they’ll soon find themselves with more business and more money for doing things better. That is the way free markets work.

    I have a huge problem with the government mandating any changes, no matter how well-intentioned. There is always, without any exceptions whatever, a law of unintended consequences that comes with this sort of legislation. Once in a great while, that unintended consequence is benign. Unfortunately, the rule is that it brings about worse conditions than those that were intended to be solved in the first place. Those problems generally beget more government “solutions” until all we are left with is a giant mess that our governors believe needs taking over.

    Look at any nationalized industry in any country that has done so. British Steel is a pretty good example. It was, 70 years ago, the pride of the world. I used Wilkinson Sword safety razors until they ran out of that pre-nationalized steel. They weren’t worth a Continental after that.

    Look no further today than PDVSA (the national oil company of Venezuela) or PEMEX (the national oil company of Mexico). Amongst oil people, they (especially PDVSA) are a laughing-stock. I’ve done work for both PDVSA and for their subsidiary CITGO through a software company I used to work for.

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