A Love Letter

Dear Health Care Industry:

There are things we love about you, but today I'm going to write about the things we do not.

1. Try listening to the health care consumers you serve. Assume their questions and concerns are valid and answer them honestly. When a health care consumer expresses concern that the blood tests ordered by her doctor might not be covered by her insurance, it's not helpful for the health care worker to say: "You're the only one who ever asked that question."

Think of it this way. A customer walks into a bar, orders a vodka and milk, and slaps a twenty down. Does the bartender say:
"You're the only one who ever asked for that."
Maybe-- but first, the bartender will mix that drink and meet the customer's need.
So, since we are no longer doctors and patients, but "providers" and health care "consumers"or better yet--customers, then treat us like customers. The customer is always right--right?

2. Call it what it is. Lab Corp is appropriately named. It's a corporation; a corporate chain that collects consumers' blood for testing. What stands out most as one approaches the sign in window is the bold lettered sign warning the health care consumer that some tests might not be paid by Medicare and that consumers should leave a credit card with Lab Corp so LabCorp can put a lien against the health care consumer's account so they (LabCorp) don't experience a long wait for their money.

3. Nobody likes to wait.

When a health care consumer interrupts the chatter of the two lab workers to ask what the estimated wait time is, he is told forty-five minutes.

4. Maybe more consumers should ask more questions.

One hour, fifty-five minutes later, the health care consumer exits the Lab Corp building, holding a piece of paper known as "Advance Beneficiary Notice of Noncoverage (ABN). The health care consumer recalls the front office agent back at the doctor's office who said the consumer's insurance always covers the blood tests, and "you are the only one who asked that question."

The Advance Beneficiary Notice of Noncoverage was presented to the health care consumer in the bloodletting room, after a one and a half hour wait, and before any blood was drawn. At the top of this paper are these words:

"Medicare does not pay for everything, even some care that you or your health care provider have good reason to think you need. We expect Medicare may not pay for the laboratory test(s) below. " The tests and their prices follow this announcement.

At the bottom of the ABN are three options, with a box to check next to each option:

Option 1. I want the laboratory test(s) listed above. You may ask to be paid now, but I also want Medicare billed for an official decision on payment, which is sent to me on a Medicare Summary Notice (MSN). I understand that if Medicare doesn't pay, I am responsible for payment, but I can appeal to Medicare by following the directions of the MSN. If Medicare does pay, you will refund any payments I made to you, less co-pays or deductibles.

Option 2. I want the laboratory test(s) listed above, but do not bill Medicare. You may ask to be paid now as I am responsible for payment. I cannot appeal if Medicare is not billed.

Option 3. I don't want the laboratory test(s) listed above. I understand with this choice I am not responsible for payment, and I cannot appeal to see if Medicare would pay.

After the health care consumer chooses an option, she/he signs and dates the document.

Curious, the health care consumer looked up the flagged lab tests to try and determine why they would be refused for the condition/diagnosis.

Test 1. Tests thyroid function. Often recommended for women over a certain age, although opinions on this vary.

Test 2. Helps diagnose certain cancers of the liver. The health care consumer whose doctor ordered this test has a chronic liver condition that is a known carcinogen.

Lab Corp's motto is "Innovation Quality Convenience."

There's nothing innovative about being told there's a 45 minute wait time and spending just shy of two hours in the place. Convenient? Not.

Quality would be putting a bandaid on the needle stick site, instead of expecting the health care consumer stop the bleeding with her finger. Leaving a huge bruise on the health care consumer's arm is not a quality move. Taking a half tube of blood for one of the tests and a full tube for the others--that's innovative!

Try this, Lab Corp. Invest a dollar in one of those erasable marker boards and update it with estimated wait times. That way the health care clerks won't be bothered by consumer questions and health care consumers can make their own decisions about whether it's worth the wait.

Or, do as restaurants do, loan pagers to health care consumers so they can step outside if they choose, instead of growing moldy sitting in your crowded, stuffy bullpen. Maybe LabCorp could charge customers a deposit on the pagers, since money seems to be their primary care (Yeah, pun intended).

Offer a discount to health care consumers who bring their own bandaids.

Corporate America offers a wealth of health care options (and payment options), except the obvious one: a single payer public health care option that covers everyone. HR676.

Everything isn't about consuming, and buying and selling. Health care isn't a commodity. It's a human need. The industry has forgotten about the human part.