If you think healthcare is expensive now, wait until you see what it costs when it’s free – PJ O’Rourke

I hope you had fun celebrating the New Year. I was supposed to be at a gay soiree – well not gay, festive. You know what I mean. I didn’t make the party. Instead I was at my computer in my office completing my compliance tests.

On the morning of December 31 I got a call from my secretary. “Dr Kurtzman you haven’t completed any of your compliance tests.”

I work at a state university. We’re hardly ever open. Certainly not the day before New Year’s. “What are you doing at work?” Caller ID had revealed her location.

Mr Picklemouth called me before sunrise and said I had to come into work and make sure you completed the tests. They have to be completed by all faculty before the end of the year,” she said. “He said only you hadn’t passed all the tests and that we’d lose all federal funding if we (she meant me) weren’t in compliance.” She paused to breathe.

“Slow down. Who is Mr Picklemouth?”

“He’s the assistant compliance officer.”

“I don’t deal with subordinates,” I said puffing out my chest. I hoped this bluster might buy me some time. “I’m not doing anything until I hear from the top guy.” I hung up. Actually, I closed my cell phone – not nearly as satisfying as slamming the phone onto the receiver. Like the top guy is going to work on a holiday.

Five minutes later the phone rang. Well, it didn’t ring it played the first few bars of Bach’s Toccata and Fugue in D minor. “Hello,” I said mysteriously.

“Mr Kurtzman? This is Mr Diddle. I’m the chief compliance officer.”

Wow, the top guy. “You can call me by my first name,” I replied. “It’s Doctor.”

“Kurtzman,” he said without missing a beat, “you have to complete your compliance tests before midnight.

“And if I don’t?”

“We’ll break your kneecaps.”

“The university doesn’t have a rule against that?” I tried to sound confident, but I have bad knees already.

“Only if you’re an experimental animal.”

I tried a more conciliatory approach. “How many do I have to do?”

“All of them.”

“All of them? How many are there?”

“Thirty seven.”

“I have to complete 37 online tests before midnight?”

“Ordinarily yes, but we are having a holiday special. Complete five at we’ll wipe the slate clean.”

“Squeaky clean?”

“As empty as your short-term memory.”

“Do I get to pick which tests I take?”

“Kurtzman, don’t push me too hard.”

“Please, call me by my first name.” He didn’t even twitch.

“You have to take Medicare compliance first. Then HIPAA…”

“What’s that?”

“You haven’t read the emails we sent everyone?”

“I never read emails.”

“You haven’t seen all the signs we have covering every wall in the building and inside every elevator? Preserve confidentiality

“I thought they were graffiti and besides I know nothing.”

He pushed pages 8389 to 8433 of the Federal Register: February 16, 2006 against my nose; how he did it through a cell phone I’ll never know. “Read these. After HIPAA you’ll do IRB compliance. You do know what that is?” Before I could reply he said, “You used to be the chair of the IRB.”

“I wasn’t the chair. I was the chairman.”

“Animal Experimentation is next. You finish with Sexual Harassment.”

Well, at least you saved the best for last.”

“I expect you here in 10 minutes. If you don’t make it by then you’ll lose your parking space.”

I was there in seven. When I arrived he had my computer on and its browser set to the Compliance Test’s web page. He had a copy of the Medicare Compliance Manual on my desk – 1200 pages, 5.2 pounds.

The manual is for you. I’ve deducted $155 from your development account.”

“But it says $154.95.” He left. I looked at the screen. It said take the video course, or take the test now, or take gas. I decided to take the test. It had 10 questions.

The first question was: Which code is appropriate for a new patient who is self referred complaining of chest pain, tinnitus, rhinorrhea, is receiving workman’s compensation from the state of Ohio, and who resides in the Aleutian Islands?

a. 92045
b. axqvd
c. both
d. neither
e. there is no such code

I clicked c. The remaining nine questions were just as easy as the first. I clicked c for each one. I then had the opportunity of submitting my answers for scoring. I clicked submit. The computers replied are you sure? I was. Four right answers. Not bad I thought, though I needed eight. The computer told me which questions I had missed and then offered some hints. I got six right the next time. I couldn’t remember which of the questions really had c as the right answer. After an hour and a half of manic clicking I got eight right. I was ready for HIPAA

HIPAA took two hours. By the time I got to Sexual Harassment it was 10 minutes before midnight. But I was hopeful. After all, I had finally reached a subject I knew something about. Much to my disappointment the test was all about pronouns, the third person singular, and words that end with man. It took me two hours to get my vocabulary right. The New Year had arrived. What was I to do? Desperate I called Charles my computer guy. He always knew what to do.

“Charles, I’m sorry to wake you up but I have a serious problem.

“Who’s asleep? Happy New Year. You still at your computer?”

“How’d you know?”

“Diddle told everyone.”

“What do I do?”

“Set the clock back three hours.”

Happy New Year all.