Dallas Caley

I just finished a 24 hour shift (with a small break for dinner) and i believe i have stumbled upon the reason why Obamacare is not the real problem with the current health care system, but before i continue i need to vent.

I work for a company which makes a software product for doctors/hospitals which among other things allows the doctors to write prescriptions electronically as opposed to scribbling them down on a dirty napkin as they have been doing for generations. The reason we even have a product and a market for this product is essentially because of obamacare (and also the 2010 Digital Health Records Act or some such thing which is technically not obamacare but is generally lumped in when describing obamacare).

The reason I say this is that from my experience most doctors actually don’t want to change anything. They are perfectly happy with sending their prescriptions in a rolled up piece of paper tied to a homing pigeon even though from any sane persons perspective it’s obvious that it is much more secure to send these prescriptions via the internet (because they can be encrypted and identities can be verified etc, etc etc…) with the old prescription system you could make 10 copies of your original prescription, go get them all filled and Bob’s your uncle

Another great thing about the new system is that now patients will be able to know how much their insurance will actually cover for any drug they might be prescribed and it will also show them lists of alternative drugs that may be cheaper. And I’m not just talking about the doctor or office person saying that the drug is covered and then you finding out 6 months later that it actually isn’t and now have a big bill to pay (which is pretty much what happens now). You will now know for a fact exactly how much will be covered before you ever spend dime one. This coverage information is what we refer to in the industry as a Drug Formulary Check and it’s a pretty tricky thing.

So why then would you suppose that doctors would not want to change to this clearly better system?  Doctor’s are smart right? what do they know that we don’t?  Well perhaps it’s because they are familiar with the current system and they know how god-awfully complicated it is. Perhaps they are afraid that the new system will add even more layers of complexity.  Perhaps it’s because they spent 12 years learning how to be a doctor and the rest of their lives learning how to navigate this ridicules system and now that they think they understand it, here we go and change everything.   perhaps?

Anyway, we just finished 6 months of hell in rebuilding our electronic prescription system and getting it certified by the government and today is the day that this new system gets rolled out and I’m the guy doing it. This new version of the system includes the Drug Formulary Check that i mentioned earlier.

Up until this point, however, we’ve been building our system using test data. Fake patients and fake drug formulary information that we can use to build and test the system, but yesterday at about 5pm I started the download of the real formulary information. Keep in mind we have a blazing fast internet connection when i say this.. The download took over 12 hours to complete! When all was said and done we had over 40 gigabytes of information!

What is all this info ask?

Well, lets see, this 40 gigs of info consists of every insurance carriers coverage info for every plan they have for every drug that is made, and relatively speaking there aren’t that many different drugs out there. What this means is that the system of determining how much you will pay is immensely complex and keep in mind this is not the obamacare system, this is the current non-obamacare system.  All we are doing is putting it in digital format.

Imagine how difficult it must be to wade through the mountains of paper our current system uses to represent this data, it’s a friggen miracle that anyone ever gets coverage for anything. Lets put some perspective on this:

Current Insurance Coverage Formulary info = 40 gigabytes

A Strand of Human DNA = 4.5 gigabytes of data

That means that our current insurance system is about 10 times more complicated than the code to create life itself! I don’t have the numbers but if i had to guess I’d say that the current insurance system makes all the other works of mankind including the lost library of Alexandria look like a cliff notes for a Hardy Boys novel. It is without doubt the most complicated thing we have ever created EVER!. In hundreds of years when we are flying our battlestars to distant galaxies it will still be the most complicated system ever made ever!

Why, why! why you ask?

It’s because they don’t want you understand the system that’s why. it’s in their benefit for you to not understand it because they can take advantage of you that’s way.  And by they, I don’t mean Obama and his cronies i mean the insurance industry.  They are the ones spreading the lies about obamacare and making everyone fear it because it is they who will be hurt the most by changing the current system.

So what are we to do?

Well the wheels are already in motion, obamacare is here and i don’t think it’s going away. Is it painful to make this transition? yes it is. There will not be an immediate benefit to most people, in fact most people will end up paying more…  At first that is.  And this fact won’t change quickly. It will take a generation for us to sort out the mess that we’ve created and for anyone to see the real benefits of this legislation but when we finally get to that day it will be worth it.

But why is this system better?

It’s better because now all the heavy lifting is going to be handled by computers.  No longer will there be any ambiguity about whether you are, or are not covered.  No longer will it take years for doctors to get paid for their work.  No longer will there be lawsuits over who should pay for what.

Also because the new system will handle all the complexity for the doctors and patients, it will become less beneficial for the insurance companies to purposely complicate the system.  Perhaps they will start to simplify their fee schedules which will make everyone happier.

Imagine if we applied this logic to other things, LIKE TAXES!  what if there was a computer program where all you had to do was press a button and it would figure out your taxes for you and guarantee that you got the maximum amount of money back using every possible deduction.  Do you think the IRS would simplify it’s tax code?  maybe they would because i’m guessing the same rule is in effect here.  Currently it makes more sense for them to make it complicated so that way they can rob you of more money.