Current Events — HabitableZone

Current Events » in reply to The system is broken

I worked in that system at United Health Care

for one year. That's all I could take of it. Lindy, I'm a top notch computer programmer that has created artificial intelligence systems that applied human thought processes to complex business systems and been very successful.

However, when faced with trying to write software to help streamline claims processing for the health care industry, I ran up against a wall of stupidity. I could mimic the human thought processes at work in the business but it became clear that those very thought processes that had designed the system were fatally flawed and forever broken. I watched every day as a sea of people struggled to make sense of the millions of claims details pushed through a sea of complexity while the rules changed by the hour. Each new contract with a health care provider simply added on to decades of bureaucracy without removing fluff that no longer applied. This wasn't by intent. The people negotiating the contracts didn't want to make them more complex. They simply could not spend all their time playing cleanup or they'd never progress forward.

I have never felt so useless in all my life even though my supervisors were extremely happy with my work and I was well compensated. The area I worked in was staffed with compassionate and caring people that were just trying to do the right thing. We weren't the bean counters that tried to find ways to deny claims. Our division helped administer Medicare and Medicaid plans for various states.

However, I often got a glimpse at our corporate masters and it wasn't a pretty sight. Despite working for a health care insurance system, employees were given costly health care benefit options that tried to nickle and dime you at every turn. It was obvious that we were viewed not as valued employees but as a source of profit. When I left, I had to keep my plans to quit hidden and use up my vacation days ahead of time or they would have been frozen and taken away from me. Little glimpses into the thoughts and ethics of the corporate leaders showed them to be micromanagers and out of touch with the daily goings on.

I'm greatly concerned about the impact going to a true single-payer system will have on the thousands of people down in the trenches keeping these huge insurance corporations running. They are not the bad guys in this. A simpler system means a large workforce will no longer be necessary for complicated claims processing. Hopefully, whatever plan is employed will be done in stages to give society time to adjust. One good thing though is that just as in any industry many of the workers are there for one main reason - the health care benefits. If the government is providing that, a good chunk of our workforce, particularly in two income homes, can then go back to the more traditional family role of one wage earner and one stay at home parent.

Art

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