The morbid cost of bureaucratic efficiency

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 Social Teaching.  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. Karl D. Stephan is a professor of electrical engineering at Texas State University in San Marcos, Texas. This article has been republished, with permission, from his blog, Engineering Ethics, which is a MercatorNet partner site.


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