Monday, November 21, 2005

Managing Care

Bill Busby, a long-time friend and fellow philosopher, is a less than enthusiastic patron of his local HMO in Albuquerque, AZ. He is also now old and a little bit crotchety, but the below-copied humor he sent along to me has a point.

Trying to manage the details of care with the details of payment is clumsy at best and infuriating (if not outright dangerous) at worst.

In the health care system of the future, care ought to be managed by doctors and hospitals. Unfortunately, their unwillingness up to now to do so has left the job in the hands of insurance companies.

Mr. Smith goes to the doctor's office to collect his wife's test results.

The lab tech says to him, "I'm sorry, sir, but there has been a bit of a mix-up and we have a problem. When we sent the samples from your wife to the lab, the samples from another Mrs. Smith were sent at the same time and we are now uncertain which one is your wife's. Frankly, it is either bad or terrible!"

"What do you mean?"

"Well, one Mrs. Smith tested positive for Alzheimer's and the other Mrs. Smith has tested positive for AIDS. We can't tell which is your wife."

"That's terrible! Can we do the test over?"

"Normally, yes. But you have an HMO and they won't pay for these expensive tests more than once in a year, so we can't repeat the test until next year."

"Well, what am I supposed to do now?"

"The HMO recommends that you drop your wife off on the outskirts of town........ If she remembers the way home, don't have sex with her.

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