This Is Not A Bill

Of all the paperwork I hate – and I find it all insufferable – I detest medical paperwork most of all. It arrives in that dreaded plain white envelope; inside a document with the legend prominently displayed: THIS IS NOT A BILL. After unfurling the treatise from its womb, I am confronted with a thicket of unintelligible jargon known as the “Explanation of Benefits.” It’s never terribly clear. Once I had some periodontal work done and it was classified as “osseous surgery.” Who knew? With that language it could have been the removal of an appendix – or some other vital, rather than vestigial, appendage. God forbid.

Other than the jargon, it’s filled with footnotes and disclaimers relating to who covered what and how much, whether the provider is a participating provider, how much of your deductible you’ve met and so on and on and on.

A 2004 news release issued by the Physicians for a National Health Program cited a study by Harvard Medical School and Public Citizen that found “health care bureaucracy [in 2003] cost the United States $399.4 billion.” (Emphasis added.) For paperwork? As the late U.S. Senator Everett Dirksen supposedly said, “A billion here, a billion there, soon you’re talking real money.”

This isn’t an argument for any particular health care reform. That’s better debated in a much more comprehensive and knowledgeable arena than this blog. There are so many players in the debate, each with his scalpel to grind. I can only hope that whatever reform comes about makes a sizable incision in that $400 billion in bureaucracy costs.

The National Center for Policy Analysis reports on its website that “some three million clerks and managers are employed in the health-care industry – nearly four times the number of doctors now practicing.” Just handling the claims alone, the center says, costs $13 billion. Now those are some telling numbers – could it be part of the reason why there’s some 45 million+ uninsured Americans?

Maybe all that money is for handling those forms you seem to always be filling out – sometimes each and every time you visit the same doctor for the same condition. Maybe it’s all the reports doctors and other professionals have to fill out. Maybe it’s some other paperwork demon.

But surely those THIS IS NOT A BILL printouts are the chief culprit. Why do we need a separate one in most cases for each and every procedure – even those done on the same day? How about a monthly recap, something like a bank statement? Can you imagine a bank sending you a statement every time you wrote a check or made a deposit?

I’m seriously considering a small protest against this excess of paperwork that’s costing us so much time, money and trees. The next time my health insurance premium is due, I think I’ll send a small piece of paper with the invoice that says, “THIS IS NOT A CHECK.” It would save them a small amount of processing time.

I would think that my insurance company would not be amused by my creativity. But, hell, I’ll feel good – and isn’t that what health care is supposed to be all about?