What if Life Was Like Healthcare (Part 2)

A very enjoyable post to write was my previous post on what if other parts of life were like healthcare?  I recently reposted it on the ACP Internist blog, and that got me thinking about more areas where life could imitate medicine.
So here is part 2 of the continuing saga.

Driving to Work

After awakening from a night sleeping on the streets (see my previous post), you get up and get ready to go to work.  You get in you car, turn the key in the ignition, but the engine doesn\’t start.  Gas prices have gone up to $150 per gallon and you have been trying to conserve, so you assume that your car is out of gas.

You call AAA to get some gas, but when they arrive you get some shocking news:  AAA instituted a \”high deductible\” plan and raised your rates without your knowledge.  This is because of previous instances when you ran out of gas.  The AAA man says you haven\’t met your deductible, but when you then ask him how much it will cost he tells you he can\’t say.  If he shares his fee schedule, other wrecker drivers may find out and fix their prices.  The government considers this fraud.  So he puts a gallon of gas in your car and gives you a bill $400, but says to wait to see if AAA discounts this (unlikely with your high deductible plan).

He drives off, and you get back in your car.  It doesn\’t start.  You call the AAA man again and he says another visit will be another full charge.  You argue that if he hadn\’t hurried off as fast, he might have picked up the problem.  He complains about reimbursement and says he can\’t afford to take that kind of time with you.  Since you have no choice, you call him back.  He changes the battery for $500 and fortunately it fixes your problem.

Finally driving to work, you notice the following:

• Rich people have very nice cars.
• Poor people all have cars.  They are not real nice, but all gas and maintenance is free.
• Many middle class people don\’t have cars; those who do have to pay enormous amounts for ones that are worse than the poor people get.
• The elderly get free cars, but can\’t afford to put gas in them.

Finding a Parking Spot

You make it to work, stopping at the gate in front of the parking garage.  To get in, you must enter the proper code on a keypad.  For each car there is a different code, and the code changes depending on how much mileage your car has, what color it is, and how what you had for dinner last night.  When you input the code, it takes 15 minutes to know whether or not it is right.  The codes used to be 3 digits long, but now there are two numbers after the decimal that specify certain specifics about last night\’s dinner:

• What the fiber content was of the food
• Where you sat at the table when you ate.

The American Automobile Association developed this coding and puts out a 2000 page guide to help you determine the proper code, although many other drivers have now resorted to spending $10,000 on a computer program that will keep track of this information for you and submit the code electronically.  The coding system, felt to not cover enough detail, is soon to be changed from the ICP-9 (I Can\’t Park version 9) to the ICP-10, which also takes into consideration the moon phase and the cash winnings of yesterday\’s winner on Jeopardy.  Nobody has determined exactly why these two things were chosen, but the computer upgrade will cost another $10,000 for those wanting to stay current.

When you finally do get into the parking garage, you find that the parking spots are all very small.  These spots are getting progressively smaller each year, with congress threatening to cut  the size of some of them by another 21%.  You find a spot and can barely get out of your car, wondering what will happen if the government cuts them by 21%.  Maybe you\’ll have to forget about the parking garage and do the valet parking.

Going out for Lunch

After an arduous morning working in the paper clip factory, you head off for lunch.  You decide to treat yourself to a nice meal, compensating for the parking lot hassles.  You sit down and the waiter hands you a blue menu.  You notice that there are no prices on the menu, and the waiter informs you that you will be told the price only after you order your food.  You really want to treat yourself, so you ask for a sirloin steak, but as you do the waiter gets a worried expression.  He whispers something to the hostess, and she tells you to come back to the front of the restaurant.  The hostess then asks you a series of questions, reading them off of a computer screen.

• \”When is the last time you had a steak?\”
• \”Have you ever tried the chicken salad?\”
• \”Did you follow the proper ordering procedures?\”
• \”It looks like you had steak last week at Outback.\”
• \”You really shouldn\’t be eating so much steak.\”
• \”Have you tried the chicken salad?\”

You notice that there are other people with different color menus who are getting very large steaks.  Some of them are paying a lot for them, while others nothing at all.  When you ask, you are informed that because you chose the blue menu you are limited to only certain items.  You are asked once again if you have tried the chicken salad.

You relent and get the chicken salad, but it is quite small and you leave the restaurant hungry.

Getting a Haircut

After work you head over to the barber to get a haircut.  You have been going to a certain barber for years.  He knows how you like your hair cut and he\’s good to talk to after a bad day.

When you enter the barbershop, however, the waiting area is packed full.  The barber looks harried and smiles at you weakly as he works on a young child\’s hair with a speed you have never seen from him.  Still, this is your favorite barber, and you think it is worth the wait to see him.

As you sit watching him, you notice that he is rushing from customer to customer.  Some of the customers are now being seen by his barber assistant (or BA), but both of them are working at break-neck speed.  You wonder how he can do quality work at all, running this fast between customers.  After waiting for an hour, you finally get seated and wait for your haircut.  Instead of his usual talkativeness, he comes at you with the scissors and begins cutting without asking you what you want.  When you object, he tells you that he has a haircut protocol he must follow.  If he follows these protocols, he explains, he will get a \”quality incentive check\” at the end of the year.  He has no idea how the size of the check is calculated, but says that he can\’t afford to cut regular any more.

Your cut doesn\’t look like you wanted, but you still like the guy, so you say nothing.  You get up and go to the cashier, who asks you for $30.  This is $10 more than you paid at your last visit.  When you complain about spending more for a worse cut, the cashier explains that the barber only sees 10% of the money from your haircut, with the rest of it going to the comb, shampoo, and hair gel manufacturers, the government (so he can continue giving cuts to the poor and elderly), and to lawyers suing him for the poor quality of his work.

\”We\’re making changes soon,\” the cashier explains, handing you a very nicely made brochure.  You open the brochure which tells you the barber is preparing to close his barbershop and open up a hair boutique.  To go to this boutique, you must pay a membership fee of $5000 per year.  But, the brochure goes on to explain, this money will get you the following:

• Hour long sessions with the barber, which include massage and aromatherapy.
• Barbering house calls if you choose (for an additional fee).
• A yearly hair health assessment, which includes a molecular analysis of your hair and a state-of-the-art computerized personal hair care recommendation.
• Access to the barber 24/7

Frustrated, you get in your car, considering why you don\’t just use the $15 \”barber-in-a-box.\”  But as you turn your key in the ignition, the car again won\’t start.  You contemplate calling AAA again, but really don\’t have the cash to pay the wrecker man again.

So you get out and walk, dreaming of living somewhere (like Canada) where there is public transit to anywhere you want to go.  They say everyone up in Canada is happy.