I found this article funny and, while exaggerated, it shines a light on the inefficiency and lack of customer service in the health care delivery system. It was written by Jonathan Rauch and published on NationalJournal.com. Happy reading!
If Air Travel Worked Like Health Care
Fasten your seat belts — it’s going to be a bumpy flight.
by Jonathan Rauch
“Hello! Thank you for calling Air Health Care, the airline that works like the health care system. My name is Cynthia. How can I give you travel care today?”
“Hi. My name is Jonathan Rauch. I need to fly from Washington, D.C., to Eugene, Oregon, on October 23.”
“Yes, I’d be happy to assist you with that. It does look like we can get you on a flight on January 23 at 1 p.m. or February 8 at 3 p.m. Which would you prefer?”
“Neither. I need to be in Eugene on October 23. As in, the 23rd of October.”
“I’m sorry, we have nothing open on that date. You might try another carrier.”
“I suppose I’d better. Who has availability?”
“I’m afraid I have no way to know that. I have no way to look into their systems.”
“Who would know?”
“You can call them individually and ask. I’m sure you can find one.”
“Look, I don’t have time to call two dozen airlines. It’s important that I get to Eugene on the 23rd. There must be something you can do.”
“Well, it looks like maybe we could squeeze you in on October 26, if you don’t mind departing Washington Dulles at 5:35 a.m.”
“Good grief. All right, I suppose it will do.”
“I’m sorry, sir, we don’t use e-mail to transmit records and other personal or secure documents. We keep our records on paper.”
“Great, thank you, I’ll be happy to make that booking for you. That’s one flight from Washington Dulles to Chicago O’Hare on October 26. Will there be anything else?”
“Wait, hold on. Chicago? I’m going to Eugene. It’s in Oregon.”
“Yes, sir. The Eugene portion of your trip will be handled by a western specialist. We’ll be glad to bring you back from Chicago to Washington, though.”
“You mean I have to call another carrier and go through all this again? Why don’t you just book the whole trip?”
“Sorry, sir, but you do need to make your own travel appointments. We would be happy to refer you to some qualified carriers. May I have your fax number, please? Before I can confirm the booking, we’ll need you to fill out your travel history and send that back to us.”
“Cynthia, I have filled out my travel history half a dozen times already this year. I’ve told six different airlines that I flew to Detroit twice and Houston once. Every time I fly, I answer the same battery of questions. At least a dozen airlines have my travel history. Why don’t you get it from them?”
“We have no way we could do that. We do not have access to other companies’ records, and our personnel have our own system for collecting travel history.”
“But 95 percent of these questions are always the same. Don’t you know that every time I fill out one of these duplicative forms I increase the chance of error? Wouldn’t it make more sense to hold my travel information centrally, so that everyone could see the same thing?”
“Sorry, sir, we have no capability for that, and we do need to have your travel history at least two weeks before you fly.”
“I don’t suppose I could fill out these forms online?”
“No, sir. The forms are only about 30 pages, though. Did you have that fax number, please?”
“I don’t have a fax machine. No one faxes anymore. Just e-mail me the forms.”
“I’m sorry, sir, we don’t use e-mail to transmit records and other personal or secure documents. We keep our records on paper.”
“What century is this? You think paper is secure?”
“We do keep all your travel records on low-acid paper and in fire-retardant file drawers. When someone needs access to your records, we make a photocopy and put them in the mail. Or fax. How many items of luggage were you wanting to bring?”
“Two.”
“OK, good. We suggest you make luggage arrangements with Rapid Air Transport, though of course you’re free to use any luggage company you like.”
“Luggage company?”
“Yes, sir. You’ll need to arrange baggage transport. Would you like a phone number for Rapid, or would you prefer to find your own baggage company? I’m sure Rapid would be pleased to work with you. All you need to do is sign the Personal Travel Records Release form. Where would you like me to mail that?”
“Release form?”
“Yes, sir. You’ll need to sign and fax or mail that back to our Travel Records Department so that we can release your travel records to Rapid. Under the privacy rules, we’re not authorized to tell them when or where you’re flying without your written permission.”
“I suppose I couldn’t just e-mail you this permission, or grant it online?”
“No. Did you want a list of luggage carriers for your Chicago-Eugene leg?”
“Let me guess. Rapid doesn’t operate out West. I have to find a separate luggage company for the second leg.”
“Yes, sir.”
“And they’ll need more copies of all the same paperwork. And they’ll ask me all the same questions. And I’ll have to arrange to get my travel records to them by mail or fax. And I’ll repeat all this nonsense five or six separate times between here and Eugene, because the providers aren’t equipped to talk to each other and my records aren’t digitized and no two providers use the same system.”
“Yes, sir, that’s right! Did you have a preferred fuelist, or did you want a reference for a company to provide jet fuel for your flight?”
“Fuelist. That would be a fuel specialist, I suppose.”
“We can make a fuel arrangement for you, but please be advised that the fuelist’s charge will be billed separately and you will be responsible for it. We’ll need to know where to have that bill sent.
“May I have your flight-insurance information, please?”
“Millennium Travel Care, group number 068832, ID number RS-3390041B.”
“I’m sorry, sir, we’re not in Millennium Travel Care’s provider network.”
“You’re listed on their website. It says you accept Millennium.”
“We did until last week. If you like, you can pay out of pocket for your ticket.”
“How much would that be?”
“Yes, sir, I’ll be happy to get that price for you. That would be $17,885.70.”
“What? For a flight to Chicago? Does anyone actually pay that?”
“I’m sorry, sir, I wouldn’t know. I can tell you that different clients and insurers pay different rates. For individuals, the rate is $17,885.70.”
“Oh.”
“In a sane system, I would call an airline and it would give me a price for the whole trip, not just for one part of it.”
“Plus tax. And fuel.”
“Is anyone else cheaper?”
“Sir, again, I couldn’t tell you that. Carriers don’t have public rate sheets. Prices are privately negotiated, so there’s really no way you could comparison shop.”
“Oh.”
“Did you want to go ahead, then?”
“No. I DO NOT WANT TO GO AHEAD. I do not want to go anywhere! I want to jump off a cliff!
“This system is insane. It is fragmented to the point of incoherence. Record-keeping is stuck in the 1960s. Communication is stuck in the 1980s. None of the systems talks to the others. Everyone reinvents the wheel at every stage of the process. There is no pricing transparency.
“In a sane, modern system, I wouldn’t have to arrange each leg of my flight myself. I wouldn’t have to fax documents around, find and juggle multiple providers, fill out again and again what are essentially the same forms every time I use a provider.
“In a sane system, I would call an airline and it would give me a price for the whole trip, not just for one part of it. It would sell me a safe round-trip journey, instead a series of separate procedures. It would have back-office personnel using modern IT systems to coordinate my journey behind the scenes. The systems and personnel would talk to each other automatically. At the press of a button, once I entered a password, they would be able to look up my travel history. We’d do most of this stuff online.
“In fact, Cynthia, I would be able to arrange a whole trip with a single phone call!”
“Sir. Please. Calm down and be realistic. I’m sure the system can be frustrating, but consumers don’t understand flight plans and landing slots. Even if they did, there are thousands of separate providers involved in moving travelers around, and hundreds of airports, and millions of trips. Getting everyone to coordinate services and exchange information just isn’t realistic in a business as complicated as travel.”
“Yes. I suppose I’m dreaming.”
“Was there anything else I could help you with?”
“No.”
“My goal today was to provide you with outstanding service. Did I accomplish that?”
[click]