Yesterday, I had a busy day at work. I was running SQL for a claims analysis of Medicare beneficiaries who had died in the Carolinas. After that I was reviewing a data dictionary for complex chronic care conditions in alternative payment models. And to take a break from that, I sketched out a table to describe the impact of the exclusionary criteria from a paper that my collaborator and I are working on a revise and resubmit. It was a productive day.
However the most important thing was a wrong number leading to an illuminating conversation.
Just got a call –“Can you help me with my health insurance policy as it got rejected at ABC XYZ?”
“I don’t think so”
“But I’m calling the health policy center, you’re supposed to help me on my policy….”
Best call of the month!
— David Anderson (@bjdickmayhew) August 9, 2018
This was worth a chuckle at first, and then I had to think more about it.
The young woman on the line was new to the area and new to insurance. She was trying to follow her new doctor’s orders and get a simple thing done. The system was working against her best efforts and then she decided to reach out for help. I’m listed as working at the Health Policy Center and my name is early on in the directory. She has an insurance policy, and this seemed like a good spot to start.
I could not help her, but I understood where she was coming from. She was trying to navigate a confusing system to take care of a problem. And the system was throwing up road blocks. And when she reached out to a seemingly plausible source of help, I was of no immediate assistance. I helped her find the member service number on the back of her insurance card and wished her well.
She did not care that I am working on an evaluation of a fascinating palliative care model. She does not care that I have a nifty little paper that has a really cool identification strategy. She just wanted to solve a health problem and let the nerds in the background work towards helping her solve actual need. This was a good reminder of the vast space between my interests and the outcomes that most people care about — can I get to my doctor or my test and can I afford to pay for that needed care?
Setting up, evaluating, arguing and assessing about the structure of healthcare delivery is critical; it shapes the hallways that the woman on the phone has to walk and it creates the choices that she needs to make, but in a day to day experience, it does not matter too much for the patient who is just trying to figure out how to follow their doctor’s recommendations to take care of a problem.