I'm having a small medical procedure tomorrow (no big deal), and in the past three hours I've fielded two calls from two different departments wanting to cancel the appt. because they don't have the referral yet. I talked my doctor's office, and they assure me the referral will be over today. It's all fine, but I am a) annoyed to have my time wasted, and b) noting that if I weren't quite insistent with the cancellation people, they would have cancelled and tried to reschedule for possibly weeks later.
Someone with less cultural capital than I have could easily have been railroaded into delaying a serious procedure for this kind of nonsense. I hate systems that are full of this much inefficiency and waste.
America's health insurance mess costs lives, people. And it's just not necessary.