OK, I’ve just got to unload this, so bear with me…
I work in the healthcare space, specifically in Medicare, for subsidiary of a major health plan, designing and writing systems to process claims and membership data for multiple clients. Part of our service offering involves a fairly simple web site that people can submit applications to purchase coverage through products our clients sell. Some of these services are outsourced to 3rd party vendors, the website included.
Recently, we received a simple change request which we need to coordinate with our vendor, to be able to accept a small piece of data—an ID, in a query string that could be optionally submitted byanother 3rd party vendor used by our client. There is already a field on the form for this data, and a corresponding field in the database to store this value. All that is being requested is that this form be able to also accept a query string containing this value.
This is a very simple change, literally requiring likely no more than 1 or 2 lines of code to handle the query string. Additionally, no transformation is to be done on the value—just pull the value verbatim from the query string and store it in the database. That’s it. Nothing more. Nada.
Our vendor comes back with a 3 page statement of work, which obviously took longer to create than the change itself would to implement, which shamelessly proposes that this change can be made, but it’s going to cost over $3600.
The thing is that I see this kind of thing happening all the time…I mean literally, all the time. Now, I am not here to argue or even discuss the origins or causes responsible for the critical state of our healthcare system as those are far beyond just this simple type of issue. However, when this type of gouging is happening—and the one being gouged accepts it not only willingly, but happily—it’s no wonder we are in the shape we’re in, paying unsustainable amounts for our healthcare. This isn’t any different than the $1500 toilet seat, or the $400 hammer, etc…
This is wrong in every way. There is so much ingnorance, or at least willingness to claim as much, behind the forces driving healthcare today, compounded by what appears to be companies making vast amounts of money off of the healthcare system because of the very fact that it is broken. If it gets fixed, that cash cow goes away. This is a problem that perpetuates itself and is grounded in a lack of standards, ignorance and greed. There needs to be accountability, but even more so there needs to be a change in culture.
There is incredible opportunity in this field, however it lies on both sides—greed on one side, improvement and quality of life on the other. Unfortunately, this is such a politically charged topic which in itself means that this will continue to be an uphill battle. However from the perspective of a technology professional, it can start here, one little step at a time, deflating the value of that simple query string and bring it back down to earth.