Surgery at Sea

People that come up with far-fetched ideas often are considered crazy at the time. It could be that some of them are. However, those whose ideas eventually come to pass are later called visionaries.

During my years at Chrysler, I liked to challenge the system with "off the wall" ideas. Sometimes, wild ideas provide fodder for a workable solution to a particularly difficult problem.

I think the time has come to apply this approach to medical insurance. Medical insurance is fast becoming the single largest cost in the auto and many other industries. In spite of all the different plans that have been tried, this cost continues to increase at an alarming rate. Maybe by coming up with some wild ideas, it would stimulate some more creative thinking.

For instance, most of us have had, at one time or another, some health problems that required a hospital stay.

When it is all done, you end up receiving a pile of paperwork from your insurance company describing what was done, who billed what, what you might have to pay, etc. If your procedure involves several doctors and specialists, you will receive numerous statements from your insurance company over a period of time instead of one consolidated statement. This is because whoever was involved in the procedure will bill the insurance company separately.

This makes for a lot of paperwork, so instead of being informed, you become thoroughly confused. What gets me is that the insurance company always pays considerably less than what the doctor bills, and then say that you may owe the difference. The difference could be considerable, especially if it was a major procedure. However, I don't know of anybody that was billed this difference. If you did receive a bill, it was for a modest amount, which probably included the co-pay.

You have to wonder what's going on. I'm sure the doctors know exactly what the insurance will cover, so what's the point of billing the insurance companies twice as much (or whatever)? To me it just creates a lot of paperwork that no one understands.

The whole thing can be simplified. Medical service providers should be treated as suppliers. That's what they really are - they supply medical services. The hospital is like a Tier 1 supplier and the doctors are like Tier 2 suppliers.

When the doctor comes to the hospital to perform a service, he or she would bill the hospital. The hospital in turn would check out the bills for accuracy as to what was done - and the costs are verified against the prices agreed to by the insurance companies. All bills are consolidated for each patient's procedure, and one piece of paper is processed through the system. There is no doubt in my mind that this would reduce administrative costs by at least 10% without changing anything - as far as the treatment the patient gets or the choices he or she now has.

Another thing is the $1,500 to $2,000 a day hospitals charge for semi-private rooms. This includes a bed, one chair, one steel nightstand and three meals a day. A nurse checks your blood pressure, temperature and pulse periodically, and if performing these chores happens to fall in the middle of the night while you are asleep, so be it. If you want TV and/or telephone, you pay extra.

Now let's compare this to what you would get on a cruise ship. For $200 or $300 a day you would get a fabulous room with a balcony, TV, telephone, three gourmet meals with waiters falling over themselves to serve you, nightly entertainment, pools and exercise rooms. Even airfare is included.

It would be hard for anybody to rationalize this wide disparity in prices. I'm going to just accept that the cruise lines can provide all these services at a much lower cost and still make money.

My suggestion: Take advantage of the cost of the services that a cruise line is able to provide and outfit a ship as an outpatient facility that is equipped to perform elective surgery. You could replace the elaborate entertainment centers, pools and exercise rooms with operating rooms and other special medical facilities. Some cruise ships already offer dialysis for much less than what any hospital would charge.

There are numerous advantages in addition to considerable savings: All the required medical specialists would be in one location to deal with your specific needs, and they would be available to cover any unforeseen problems that might come up.

Your recuperation would be much more pleasant. If you were recuperating from a cataract operation, for example, instead of being incapacitated in your home for a couple of days, you would be taken care of by available attendants. Meanwhile, you could enjoy the company of other people within the relaxed atmosphere of a cruise ship.

All operations would be scheduled while in port, and if the port happens to be in Mexico or Canada your prescription drugs would cost considerably less.

There would be no problem getting help because cruise ships go all over the world to get capable people at the best prices. It would be no different than companies going overseas to get low-cost manufacturing.

Finding doctors shouldn't be a problem, either. I think there would be a lot of doctors that would like to see the world while they practice.

This all may sound a bit crazy, but I don't think so. If nothing else, maybe it'll get people thinking so a real breakthrough solution will be found.