Friday, August 14, 2009

Introducing the Healthcare Advocate

I wrote up a quick article called the Healthcare Advocate on the Medical Savings and Loan site.

My thoughts on the issue are as follows:

A Medical Savings and Loan cannot auto-approve all loans or medical expenses. For example, it would need to prevent people buying a car with a medical loan.

There has to be a bureaucratic layer in the process. My mind turned from wanting to eliminate a bureaucracy to the question of making a bureaucracy that works for the policy holder.

When I worked in the insurance industry, I developed great respect for the claims adjusters. These people learn all of the ins and outs of the system. The problem is that their knowledge is spent in the benefit of the company and not in the benefit of the client.

It dawned on me that, in a medical savings and loan, money flows from the client. As such, the claims adjuster would evolve into the role of a healthcare advocate. The goal of the advocate is to help you fit your healthcare needs into your budget. Rather than denying claims, the advocate would take the tact of talking out of spending your money poorly.

A good advocate would be more than a naysayer. The advocate would be trained to see your life as a continuous entity. A good advocate would talk you into spending on care that reduces long term expenses.

The health care advocate would have detailed knowledge of the health expenses that we will all face and would spend a great deal of time with clients in the medical savings and loan on budgeting and balancing their care.

Readers of this blog may have noticed that I've given a great deal of praise to a profession called "The Doula.' The doula can be seen as a lay position that helps mothers in the birthing process. These are trained professionals who help expecting moms with all of the stuff surrounding birth including birthing classes, post-partem depression, etc.. A good doula provides assistent and support for the mother, but avoids getting in the way of the real medical.

I imagine the position of claims adjuster evolving toward the doula model. The system might even evolve to the point where the health care advocate is a nurse practicianer who can deliver primary care and really help clients delve into their medical records and take a more active role in their health.

The Healthcare Whisperer demonstrates the type of thing that would be common if we could just break the political obsession with third party payment systems and return to self-funded care.


Scott Hinrichs said...

This position could be likened to using a financial planner. Not a bad way to go.

y-intercept said...

I think the health advocate position in a Medical Savings and Loan might even end up helping optimize the doctor's time with the patient.

Insurance companies and government have a strange way of diverting doctor's attention away from the patient into the inner workings of their strange political world.

The health advocate would be working directly with the patient to optimize the return for the investment in the doctor's time.

For example, a doctor might say something important to a patients. The health advocate could do the re-inforcing work that needs to get done to get the message through.

As I understand doulas can reduce the amount of time a doctor must spend with a patient.

The part I like is that the health advocates could come from that massive pool of people looking for career changes.