Sunday, August 2, 2009

Healthcare at the Department of Motor Vehicles?

Two weeks ago, my eleven-year-old son nearly died. Truly. One evening, he suddenly had an extreme allergic reaction and was well on his way into anaphylactic shock when we rushed him to the nearby hospital. As my wife drove him to the emergency room, his windpipe was closing, his entire body was covered in hives, and panic was beginning to show in his eyes. If this had happened one or two hundred years ago, I think we would have lost him. The very thought makes my heart ache.

Fortunately, we have a hospital only five miles away. And when he arrived at the emergency room desk, they took one look at him and immediately escorted him to a room where he received treatment. Three minutes didn’t elapse between his entry into the lobby and action to make him better. He left the hospital a couple of hours later almost back to normal. When he arrived at the hospital, there was no fuss over insurance or how much money we had with us – they just did the right thing and treated him correctly and instantly, no questions asked.

So I ask – what is so wrong with our healthcare system that we feel the need to involve the federal government into its operation?

Only three weeks ago, my family entered another lobby where we had a need to get help from the workers there, but we had an entirely different experience. Upon entering, we were told to take a little paper number from a dispenser and wait for the next available employee – even though we were the only people in the place. We sat in a chair – staring at the three workers behind counters in the room – and waited patiently until one of them advanced the number on the board and called us over. Things immediately began to go wrong, as this person informed us of some differing rules about our need – different than what we had read on their website, and different than the instructions I had been given by one of their employees at an earlier visit. The upshot was that our cost was going to be an extra (and unanticipated) $350.

As we moved to the second employee for processing, our frustration was visible. She had to know what the problem was, because she was sitting only ten feet away from the first worker. But she went about her scripted business, a little slowly, until she got to the part where the $350 issue lay. And she informed us that our original understanding was correct – in complete contrast to what the first person had said. I asked some pointed questions – the two employees shared a look – but no explanation of their disagreement was made. After signing some more paperwork, we were told to go back and wait for the third and final employee to call us forward.

So we went back to our chairs, clutching our little paper number, and watched the third employee rustle some papers behind the counter, walk around a bit, and then go sit behind a computer screen for a while. By this time, there were two or three of us in the lobby, looking at our little paper slips, and waiting for this gentleman to call us forward. When he finally did, I leaned over to all three of my children and said, “Take a lesson from this. It’s what happens when the government is put in charge of something.” Because - you may have already guessed – we were at the State Department of Motor Vehicles.

I tell these two stories for a very specific reason. When the government gets involved in something, it invariably introduces waste and inefficiency. The employees behind the counter at the DMV have very little incentive to please us or make our experience pleasant. There are no competing offices in the state to get your driver’s license – they are a monopoly. In contrast, the hospital is a for-profit enterprise. I have choices about where to take my son when he has a reaction, as there are two other hospitals within ten miles of my house, as well as numerous urgent care clinics. For some reason, when the profit motive is taken away, people tend to get lazy.

Our society seems to forget this fact sometimes. Congress is now involving itself in the regulation of executive bonuses at financial institutions and publicly traded companies, because some of these awards seem “unfair”. The government-sponsored “cash for clunkers” program ran out of money after only one week, because the feds grossly underestimated the popularity of a plan that uses taxpayer money to get people into new cars that many likely cannot afford (it’s like the housing bubble all over again – I wonder how many of these auto loans will go into default a year from now). And the car dealers in this same program are worried that they will not get the promised reimbursement from the government because the federal websites keep crashing. And you should see some of the ridiculous things that auto dealers must do to “kill” the clunkers that they receive (and essentially torpedo the used car and salvage markets at the same time).

Bottom line, I don’t want the day to arrive when I am clutching a little paper number in my hand while sitting in the lobby of a government-sponsored health care clinic, awaiting a decision and a doctor to treat my son, while he slowly chokes to death in my arms. Do you think that can’t happen? Just try asking for something quick or out-of-the-ordinary at your local government-operated Department of Motor Vehicles.