Falling apart: Systemic

One of the bad moments with this current job was when I realized that it is sucking the life out of me at a level similar to taking care of my mother did toward the end. The levels of mental beating down, the wearing on executive function, and the overall tiredness are similar.

This job definitely pays better, but the compensation with the care giving is that I knew what I was doing was important and necessary, at least based on the resources we had.

That is less clear in this case.

I provide phone support for a few different health plans. Two of them are Medicaid programs; the rest are Medicare supplements. That means that our members are on these plans due to disability, poverty, or old age, often with a certain vulnerability.

I understand the necessity of my job in that navigating health care can be confusing and require assistance. I can't help but know how much of that is because we make it hard to get health care. The  obstacles are put there to save money, prioritizing money over health.

That is not necessary.

When we are talking the worker shortage, understand that it requires thousands of people to administer insurance. We have built an entire industry around limiting health care, and then helping people navigate those limits.

Those are the people working for the insurance companies, definitely, but also the government employees trying to work out the alternatives need when medical care is tied to employment. It requires a whole field of people who are capable of translating medical reports into correctly coded claims that have a chance of being paid, then another field of people checking those claims for errors that can potentially result in non-payment.

I do not only talk to our members; I also talk to people checking the status of claims, or complaining about rejected claims or trying to understand them and get them corrected.

A large portion of these callers are based in call centers in India. While they are often very friendly and professional, the language barriers and the general complication of medical claims and insufficient training results in lengthy calls, where I may answer the exact same string of questions for every claim for the same member, then do it all over again for a different member.

This is not efficient! 

I mean, if they are paid cheaply enough it might be cost-efficient (though probably exploitative), but that is a big part of my volume increase, and it's hard to feel like it is benefiting anyone.

Placing obstacles to health care means some won't get it. It's not even always something where the plan says "NO', but there is an error in the navigation. 

More than once, I have had someone tell me that I saved their life. That was usually just sending an e-mail, but they needed someone to do it, and it hadn't been done yet.

The lie of capitalism is that through competition eventually there will be better results for everyone. 

That might have been more true when unions and protective legislation were strong, but we are past that now. I am not even proposing capitalism or socialism as the answer, at least not in the Marxist sense, for various reasons, but the preeminence of capitalism needs to be challenged.

I know that people are more important than profits. That makes an already difficult job -- and certainly not the highest in profits because of my specific area -- more difficult.

But I stay, because I need income.

"Essentially we all live in the same country, called capitalism." -- Bong Joon Ho

There are two specific things driving call volume that leads to even worse issues, so count on at least one more post.