Although tax season has come and gone again in the US, many of us have had the regrettable occasion to call the Internal Revenue Service (IRS) call center to ask a question or confirm a policy or procedure. (and no, this blog is not at all about the recent IRS scandal–I promise). At least in my case, the call center can quickly become an endless loop nightmare of computerized voices and it is very easy to get lost in the depths of the “automated menu” if you are not careful. Often, calls to the IRS call center involve hours of hold times–even my most clever tricks such as pushing “0” at every prompt and claiming ignorance once an actual human being comes on the line doesn’t always help. Large government agencies are often unwieldy and thousands of employees may be located in call centers in vastly different parts of the country–often these employees have very different understandings of policies and procedures and the agency often lacks standardization in response to consumer inquiries. In addition to IRS call centers, there is an IRS website with numerous difficult to understand PDF files of tax rules and regulations (which sometimes appear to be written in some ancient language).
Because of my experience with the IRS (government run) call center and website, I was intrigued while reading the New York Times today when I came across an article describing the Federal government’s plan for developing an “Affordable Care Act” Call center. According to the Times, the call center will be tasked with handling all of the questions and consumer issues that will begin to occur this fall when the health exchange requirement portion of the “Affordable Care Act” goes into effect. The Obama administration apparently realized this past week that most states are completely unprepared for setting up the required “marketplaces” where Americans can buy health insurance that will be required by law starting January 1, 2014. (really, we are unprepared to insure millions of new patients in just a few short months?) The government proudly announced plans to create a website AND a call center where Americans can go and prepare themselves for the October 1st opening of the marketplaces. The call center will be staffed with nearly 9000 operators who will be available 24 hours a day to make sure the every American understands the new health care act and its provisions. (I would love to meet just one of these 9000 as almost no practicing physicians in the US today fully understands the new health care act and its implications). Although this call center will create much needed jobs, it will also increase the costs associated with health care reform as even more government employees will be required to fill these roles. I expect that this call center (as well as the website) will not be the holy grail and fountain of information that our government expects it to be. The new healthcare law is incredibly complicated and is confusing for almost all of us. I am not sure how the average American is going to be able to understand and interpret all of the rules and regulations and make well informed choices as the new healthcare exchange deadlines approach.
There is no doubt that the healthcare system in the US is on life support. Our nation spends more dollars on healthcare per capita than any other industrialized nation on earth. Our costs are high and our outcomes are similar to other industrialized nations where costs are not nearly as astronomical. Obviously changes in our current system need to be made BUT I am certain that the current “Un-Affordable” Care Act is NOT the answer. The legislation is complex and expensive. In addition, moving this legislation forward when the states and other government organizations lack the infrastructure to support it is irresponsible. As a nation, we need to regroup and take from the Affordable Care Act those things that are both good for American citizens and fiscally responsible and leave the waste and political provisions behind. A Call Center and website will NOT make the new Affordable Care Act any more Functional or Affordable–and will not facilitate the establishment of the enormous state by state infrastructure required for its implementation.