Bureaucracies are technology, you know. When you hear the word
"technology," the first thing that springs to your mind may be a
piece of machinery, or a technical discipline such as electrical engineering,
but probably not the U. S. Postal Service or Medicare. Nevertheless, just like pieces of
machinery, bureaucracies are designed by experts to achieve certain purposes,
and if they fail to achieve those purposes, you can have a disaster that is
fully as harmful as an explosion or a fire due to purely mechanical causes. Think Hurricane Katrina and the Federal
Emergency Management Agency.
The little bureaucratic malfunction I will draw your attention
to today is not a disaster. Some
may not even see any problem at all with it. But to me, it is evidence that the bureaucracies we
increasingly deal with as citizens of modern societies are failing to treat us
like people, and more like machines or units of production in a giant factory.
As many readers of this blog already know, my
father-in-law Ben Simons passed away last Feb. 7, after living with my wife and
myself at our house for over eight years.
We were with him more or less constantly for the last few days of his
life. To the extent possible, we
made his passing as comfortable as we could make it. At a memorial service for him held at our church, dozens of
friends and relatives shared their memories of his good nature, and we heard
encouraging words about meeting him again in Heaven.
Contrast all that with a letter I received yesterday, from
which I quote:
"Dear Ben Simons:
Thank you for having a Humana Group Medicare plan. It was
our pleasure to serve you.
Medicare confirmed your disenrollment from your Humana
Group Medicare Advantage plan.
After 02/28/2015, Humana won't cover your healthcare. If a provider needs to send your claims
to Medicare, tell him or her there could be a short delay in updating your
records. . . . "
Now, it can be said in defense of Humana that their
bureaucracy faces the difficult task of serving thousands, if not millions, of
customers with a minimum of needless expense. So the expedient they have chosen, after advice from
lawyers, efficiency experts, and computer programmers, is to respond to a
customer's death by sending out the form letter from which I have quoted
above.
It is written to cover any and all cases in which a person
"disenrolls" from Humana Group Medicare Advantage—switching to
another plan, winning the lottery and not needing any kind of health insurance,
leaving the country to join the French Foreign Legion, or dying. And I suppose it works, in the sense
that it lets survivors know that Humana knows that the party in question has
died.
But if they knew he died, and not simply that he
disenrolled for some other reason, you would think that somehow, someone could
come up with a better form letter than this one. It could start with "Dear Survivors" and say a
little about how sorry the firm is that they have lost a customer this
way.
No, death does not fit into the bureaucratic picture. The great German sociologist Max Weber
recognized bureaucracies as one of the most significant developments of the
nineteenth century. The ideal
Weberian bureaucrat can function like a machine. One of Weber's nine main principles of his
"legal-rational model" for bureaucracies is the supremacy of abstract
rules, which machines can obey better than people can. If minimizing expenses is a high
priority, and one form letter can cover all cases of disenrollment, then the
rules say to go with it, even if the survivors of dead customers get letters
addressed to the deceased as though they were not only living, but that their
chief concern was what Humana was going to do with them now.
And of course, this letter had virtually no contact with
human hands. Some programmer wrote
it with nobody particular in mind, another programmer determined the situations
under which it is printed and mailed, and it would be a hard thing to find out
exactly who, if anyone, was responsible for sending it. It is signed only "Humana's
Enrollment Team." There is no
doubt some person or committee in charge of Humana's enrollment team, and if I
brought this matter to their attention, they might give it some thought. But if they are under cost pressures,
they would decide that, however tacky such letters look in the hands of
survivors, it would be too much trouble to come up with a special letter sent
only to survivors of deceased clients.
So they wouldn't bother with my little issue, and I'm not going to
bother them with it.
There is an engineering ethics lesson here, I
believe. Bureaucrats and
programmers and systems analysts everywhere need to remember that their
ultimate job is to serve people—not the boss, not the system, but people. I'm currently reading a book by Anthony
Esolen called Reclaiming Catholic SocialTeaching. The gist so far is
that if you leave God out of your social calculations and plans, you will go
far, far astray. Maybe not all at
once, but you will inevitably end up, not with a society, but with simply an
ant-hill-like heap of individuals.
And you will be tempted to treat members of society not as people, but
as faceless units of production or profit.
As a bureaucracy, Humana did its job well. They dealt with hospital bills so
obscure and complicated as to make the most mysterious passages in the Book of
Revelation look as plain as day by comparison. They helped provide good health care for my father-in-law
during his lifetime. However, man
does not live by bread, or health care, alone. And it is perhaps too much to expect acknowledgment of loss
or sympathy from a bureaucracy designed mainly for efficiency. We have received many messages of
sympathy and concern from our friends and fellow worshippers, for which we are
thankful. And I think we have
learned a lesson about where help can really come from.
Sources: In writing this blog, I consulted the Wikipedia
article on Max Weber. Anthony
Esolen's Reclaiming Catholic Social
Teaching: A Defense of the
Church's True Teachings on Marriage, Family, and the State was published in
2014 by Sophia Institute Press.
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