What if buying a car was like buying health care?
The material below was an illustration from a sermon on health care in the U.S. that I delivered at the Unitarian Universalist Congregation of Gwinnett in Lawrenceville, Georgia on January 27, 2008. -- Dave
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People working for health insurance companies and managed care providers are also frustrated by the inconsistencies and inequities of the system. Many hate being put in positions where they are rewarded for denying coverage. The entire system has an absurd Through the Looking Glass quality to that has us not sure whether we should laugh or cry.
Let me try the former approach to see if that provides any perspective. What if buying a car was like dealing with the healthcare system? You know I’m an amateur actor, so please pretend that I’m standing in line behind a few people at a new car dealership, waiting to talk to the receptionist, played by Lily Tomlin. She’s seated behind a tall, circular reception station, and wears a telephone headset.
The middle-aged man at the head of the line says, “I’d like to buy a car.”
“May I have your auto insurance card, please?” [in Tomlin’s voice]
“Sure, here you are.”
“Thank you.” Lily photocopies the front and back of the card and hands it back. “There’s a twenty dollar co-payment to see a sales person, sir. How will you be paying?”
“Use my Flexible Automobile Spending Account card, please,” says the man.
“I can pay for gas and oil changes and maintenance using pre-tax dollars.”
“Very good, sir. A sales person will see you shortly. Have a seat up front, please.”
The man leaves and takes a seat on some very nice padded leather chairs in the front near the plasma TV.
________________________
The next person in line is an older woman, clearly a senior citizen.
“How may I help you?”
“I’d like to buy a car.”
“May I have your auto insurance card, please?”
“Certainly. Here’s my AutoCare card.”
“Very good, ma’am. We’ll have one of our sales people join you shortly to show you our selection of Part A $500 vehicles for our clients with AutoCare. There will also be details about the Part B mechanics in our service center and our special new Part D gas and oil change plan.”
The older woman smiles and Lily looks closer at the card.
“I see you have supplemental coverage as well, ma’am. That will qualify you for vehicles with air conditioning and power steering, not just our standard AutoCare offerings. Please have a seat in the center section.”
The older woman departs and takes a seat on some cloth covered chairs next to a coffee table covered with stacks of back issues of Modern Maturity.
________________________
The next person in line is the young woman who’s right in front of me.
“How may I help you?”
“I’d like to buy a car.”
“May I have your auto insurance card, please?”
“I don’t have auto insurance.”
“Oh dear, you shouldn’t be in this line. There’s a separate line if you need to see a sales person on an emergency basis in the rear of the building. Please go there.”
“But I have money. How much is that car over there.”
She points to one of the small hatchbacks labeled AutoCare Special near the center section of the showroom floor where the older woman is waiting.
“One moment, please. This is not our standard operating procedure.”
Lily pulls out a large black binder, flips through pages for a few minutes, and finally finds what she’s looking for.
“That vehicle is $117,522.”
The young woman gasps. “Why is it so much? You said it was $500 before?”
“That is only for individuals with AutoCare insurance, ma’am. It’s regulated by the federal government.”
“But 117 thousand dollars is far more than it’s worth.”
“We have to make up the money we lose on government contracts somehow, ma’am!”
“What about that car over there?”
“If you have to ask, you can’t afford it. Have you considered public transportation?”
The young woman, dejected, starts to walk away, then turns and asks,
“Which way to the emergency sales reps?”
“Out that door and around the back.”
________________________
Finally it’s my turn.
“How may I help you?”
“I’m thinking about buying a car.”
“Thinking, sir?”
“Yes, I’m thinking about it. I’ve got great auto insurance, but I’m not sure which car I want to buy or if I want to buy from this dealership. I’d like to get prices on vehicles, read up on performance, mileage, reliability, customer satisfaction with your service and maintenance, all that stuff, before I buy.”
“We don’t do that, sir?”
“Why not? How else can I make an informed decision?”
“You wouldn’t be able to understand the technical information, sir. It takes years of training to become an automotive engineer or a certified mechanic and it’s just not something a layperson can comprehend.”
“I’d still like to have the information.”
“I’m sorry, sir, but it’s not in your best interest for us to provide that information. It is too easy for an untrained person to misinterpret the material.”
“You mean it’s not in your best interest.”
“That is correct, sir. Have a nice day, sir.”
And so it goes…
________________________
People working for health insurance companies and managed care providers are also frustrated by the inconsistencies and inequities of the system. Many hate being put in positions where they are rewarded for denying coverage. The entire system has an absurd Through the Looking Glass quality to that has us not sure whether we should laugh or cry.
Let me try the former approach to see if that provides any perspective. What if buying a car was like dealing with the healthcare system? You know I’m an amateur actor, so please pretend that I’m standing in line behind a few people at a new car dealership, waiting to talk to the receptionist, played by Lily Tomlin. She’s seated behind a tall, circular reception station, and wears a telephone headset.
The middle-aged man at the head of the line says, “I’d like to buy a car.”
“May I have your auto insurance card, please?” [in Tomlin’s voice]
“Sure, here you are.”
“Thank you.” Lily photocopies the front and back of the card and hands it back. “There’s a twenty dollar co-payment to see a sales person, sir. How will you be paying?”
“Use my Flexible Automobile Spending Account card, please,” says the man.
“I can pay for gas and oil changes and maintenance using pre-tax dollars.”
“Very good, sir. A sales person will see you shortly. Have a seat up front, please.”
The man leaves and takes a seat on some very nice padded leather chairs in the front near the plasma TV.
________________________
The next person in line is an older woman, clearly a senior citizen.
“How may I help you?”
“I’d like to buy a car.”
“May I have your auto insurance card, please?”
“Certainly. Here’s my AutoCare card.”
“Very good, ma’am. We’ll have one of our sales people join you shortly to show you our selection of Part A $500 vehicles for our clients with AutoCare. There will also be details about the Part B mechanics in our service center and our special new Part D gas and oil change plan.”
The older woman smiles and Lily looks closer at the card.
“I see you have supplemental coverage as well, ma’am. That will qualify you for vehicles with air conditioning and power steering, not just our standard AutoCare offerings. Please have a seat in the center section.”
The older woman departs and takes a seat on some cloth covered chairs next to a coffee table covered with stacks of back issues of Modern Maturity.
________________________
The next person in line is the young woman who’s right in front of me.
“How may I help you?”
“I’d like to buy a car.”
“May I have your auto insurance card, please?”
“I don’t have auto insurance.”
“Oh dear, you shouldn’t be in this line. There’s a separate line if you need to see a sales person on an emergency basis in the rear of the building. Please go there.”
“But I have money. How much is that car over there.”
She points to one of the small hatchbacks labeled AutoCare Special near the center section of the showroom floor where the older woman is waiting.
“One moment, please. This is not our standard operating procedure.”
Lily pulls out a large black binder, flips through pages for a few minutes, and finally finds what she’s looking for.
“That vehicle is $117,522.”
The young woman gasps. “Why is it so much? You said it was $500 before?”
“That is only for individuals with AutoCare insurance, ma’am. It’s regulated by the federal government.”
“But 117 thousand dollars is far more than it’s worth.”
“We have to make up the money we lose on government contracts somehow, ma’am!”
“What about that car over there?”
“If you have to ask, you can’t afford it. Have you considered public transportation?”
The young woman, dejected, starts to walk away, then turns and asks,
“Which way to the emergency sales reps?”
“Out that door and around the back.”
________________________
Finally it’s my turn.
“How may I help you?”
“I’m thinking about buying a car.”
“Thinking, sir?”
“Yes, I’m thinking about it. I’ve got great auto insurance, but I’m not sure which car I want to buy or if I want to buy from this dealership. I’d like to get prices on vehicles, read up on performance, mileage, reliability, customer satisfaction with your service and maintenance, all that stuff, before I buy.”
“We don’t do that, sir?”
“Why not? How else can I make an informed decision?”
“You wouldn’t be able to understand the technical information, sir. It takes years of training to become an automotive engineer or a certified mechanic and it’s just not something a layperson can comprehend.”
“I’d still like to have the information.”
“I’m sorry, sir, but it’s not in your best interest for us to provide that information. It is too easy for an untrained person to misinterpret the material.”
“You mean it’s not in your best interest.”
“That is correct, sir. Have a nice day, sir.”
And so it goes…
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