Having an order take 10 business days to process after being promised it would take 3 – 5 days?

Calling up 3 times to chase it up?

Not knowing the cost of services you are purchasing?

Signing up to paid membership with benefits, yet not being able to fully understand what it is you are paying for?

Repeating your details every time to different suppliers, who are interconnected?

Lost in a sea of jargon and complicated concepts?

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If these exist in your industry or company, it probably wouldn’t be very succesful (unless of course you are a monopoly).

Well this is my experience with the healthcare system and my private health insurance provider.

I sure I’m not the only one. I’m rather pissed off at my health insurance company and the general lack of communication and cohesion in the industry.

Accessible medical information online

Firstly, I am annoyed at having to repeat my details to every single supplier along the chain. From the various doctors, specialist doctors, specialist specialist doctors, hospital staff. Don’t they ever talk to each other – instead we’re handling around letters of recommendation, x-ray diagrams, medicine prescription slips, etc… Couldn’t we have a centralised database where we can access all our medical data in one place? If there was an emergency and you were admitted to hospital, they could easily pull up all your medical records. Or perhaps, I could stroll into any medical office to see a specialist and they would see all my details.

There are privacy issues with such an approach, but a user and supplier would be greatly convenienced if such facilities were available. I noticed that my health insurance supplier has a member log in available, but it still doesn’t tell me what benefits are available for my level of cover. Wouldn’t you think that this would be a very basic information request?

Instead, we are left to call up and be put on hold for 5 minutes or more, whilst listening to “we’re busy, please call back during quieter times” messages. What kind of business are they running?

I’ve come across several initiatives one of these being Google Health (y’all know Google is in everything), where the information is stored in the cloud. There’s also Glide Health which I saw during TechCrunch 50, where all the information is accessible from the platform – family medical history, past medical results, etc… I was quite impressed when I saw the demo.

Managing my health provider information and claims

Everytime I need information, I generally need to call up. In fact, it is written in the forms please speak to your “doctor, hospital, health care provider”. Why can’t these parties also collaborate in giving me information, instead of me making 3 separate requests? Well its, 5 actually because there’s another party involved. I have no doubt that these parties are NOT working together unless I give them the information. Rather there should be one central place where they can be notified of what is going on and I can see the progress.

Also, if I have to put in a request or claim, I need to chase it up – 3 times. No one within the organisation has been notified to progress the request either. Per above, there should be a tracker of all claims and requests. A bit of transparency and openness would do wonders for this industry, which thrives on people not knowing what they are paying for and charging them every month for it.

Making sense of medical insurance

There’s a lot of jargon used in this industry and when you speak to people on the phone, I do not feel that they are very good at explaining the concepts to you. I’ve read my policy and FAQ on the website, and its only having asked someone working in the industry and speaking to my health fund and doctor a few times that I have understood what is going on.

But I still don’t have a sense of how much I’m supposed to be paying, even though I’ve paid for most of it in signficant out of pocket expenses – cause I’m still waiting for one person in the supply chain to get back to me.

I could have done more research and asked around, but you don’t really have a choice in these matters. Sometimes you just need to get things done. I feel like the public (especially people like myself) need greater education on our health system and how it works.

And I’m starting to understand the divide between the public and private health insurance industry. With a private hospital, there is little waiting time if you have private health insurance and are willing to pay for the extra expenses. However with the public system, it is free or your health fund can cover you as a private patient in a public system. But the offset is that there is a waiting period. It could be anywhere from 3 to 6 months or longer.

I’m out like our health system,

Matt.