After my daughter was born too early, I received a nearly 30-page hospital bill. total? Pennies are less than $1 million.
I was not panicked. I know I am not responsible for the full amount. I wish I could be close to the maximum of out-of-pocket expenses and I was lucky enough to be in the position where I could be.
But I still find myself at a loss.
Page after page, I’m trying to decode what I owe, what’s going to cover, what’s still pending and how to connect with other bills I’ve already received – from anesthesiology, labs, experts and services, I didn’t even realize we’ve used it.
All I can think of:
How should anyone understand this? Who are you calling? Who do you trust?
The system was not built for cruelty, but that didn’t change the feeling of it. In that moment, it is confusing, disoriented and deeply isolated. This is harmful. This is mean.
That’s the bulk of our healthcare system.
When we hear about healthcare “cuts”, it usually sounds like bad news: fewer service services, narrowing the network, rising premiums.
But if the sort of cuts we should be talking about is really making care better cuts? Like cutting chaos. Because for many people, the biggest barrier to healthcare access is not cost or availability – it is complicated.
Even with insurance, trying to find a provider, check coverage and schedule an appointment often feels like being in a maze. It’s frustrating, slow, full of dead ends.
Then there is the cost chaos. Surprising bills and unclear pricing have made people guess for a second time whether to seek care. It’s no surprise if you have to take a few hours to understand your coverage, or avoid the hours.
And this chaos doesn’t end after the date – it keeps people from following care. About 50% of people with chronic diseases do not take medication as prescribed. Missed follow-up visits. Refer to an external plan. Patients did not receive the required guidance.
Every day, the emergency room sees patients because people don’t know where to turn – because the system is so chaotic and hard to use – they end there. Even if a person feels good, the system is confusing. But think about how pain can alleviate our problem-solving ability?
Consider a person with diabetes who needs to go to the emergency room to have dangerous high blood sugar and spikes in blood pressure. The emergency room currently solves the problem – but patients are often discharged without a clear plan. The result is that patients like this repeat backhaul to the ER, and they need coordinated care and condition management.
These stories are not uncommon. When care is unclear, chronic conditions worsen, small problems snowball and costs rise – for patients and employers.
Cutting the chaos seems impossible unless you are a friend with a top doctor, or have a healthcare-versed friend who can help you go wherever you go, see who and get you in quickly. The ability to navigate healthcare should not be a privilege – it should be built into the system.
Chaos shouldn’t be a big obstacle. Healthcare should not require internal knowledge access.
One of the biggest opportunities for change is employer-sponsored health care. More than 50% of Americans get health care through work, but most employees don’t fully understand their benefits. At the same time, employers are bombarded with too many solutions, too many choices, too little time to understand them.
Many CEOs spend only about 15 minutes a year during the budgeting process to review healthcare decisions. But those 15 minutes will affect every day’s employees. It deserves more time–clearer.
If the benefits are difficult to control, they will be useless. When this happens, costs pile up – some obvious, such as rising claims, and some subtle, such as absenteeism, disengagement and a decline in health.
Instead of stacking More portals, more steps and more complex information, we should ask: What should we do eliminate?
Healthcare solutions should not only be incremental—sometimes, the answer is subtraction.
Healthcare should be simple, easy to access and human. This means they need to be virtually prioritized and provide flexible care for a busy life. If this is done for their lives, people are more likely to interact with health care and stay engaged. Solutions also need to include pre-reviewed high-quality providers to help eliminate patient speculation and research. Finally, they need to remove (or keep it low) out-of-pocket expenses so that employees can actually afford the benefits of using clear spending and clinical outcomes.
It’s not just about extending access. It’s about building a health system that suits people, not against them.
If we want an effective healthcare system, we need to stop adding noise and start cutting it off.
Image source: Aleksei Morozov, Getty Images
Teira Gunlock is the CEO of First Stop Health. She is a Missouri native with a Master of Health Management from the University of Missouri.
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