Medical Wasteland

I've been wandering in the wilderness--the medical records wilderness, that is--for 40 days as I've waited for my records to travel from Duke Eye Center in Durham to Academy Eye Associates in Chapel Hill, 10 miles down the road. I should have hired the Pony Express.

You'd think that living in "The City of Medicine," with all its high-tech institutions and technologies, would result in equally high-tech efficiency. Not so. It took 3 faxes and 10 phone calls to complete my relatively simple request.

In the midst of this frustration, I was reminded of T. R. Reid's excellent book on health care, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. In it, Reid takes his sore shoulder around the world, consulting with doctors in France, England, Canada, and other countries in search of ways not only to treat his shoulder, but more importantly, for ways to improve American health care. For as he notes in his introduction, in addition to our inability to provide services for all of our citizens, "the United States also performs below other wealthy countries in matters of cost, quality, and choice."

When it comes to medical records, France has us beat by a long shot. Everyone over the age of 15 carries a carte vitale, or the "card of life," a green, plastic credit card that contains complete health information since 1998. Patients can take this card to any doctor or hospital in France and their medical history is instantly available. The card also contains insurance and billing records, so that payments and reimbursements are handled automatically. The layers of administrative processing that we encounter daily are simply not needed in France.

We've all been fasting in the medical desert of American health care for too long. For even if we're lucky enough to enjoy the finest medical services, we're still paying for bloat and inefficiency.

It's past time to emerge from this wasteland.