A U.S. Postal Service worker unloads packages from his truck in New York City, April 13, 2020. (Mike Segar/Reuters)
As the United States Postal Service (USPS) stagnates financially, ideas for expanding the agency’s business model are a dime a dozen. Some lawmakers and commentators, for instance, have suggested getting the USPS into the banking business — despite the agency’s lackluster foray into other financial services. And now, some are raising the seductively simple proposal to have mail carriers check on the elderly for a fee in addition to performing some basic health checks. This idea would not only lead to further labor disputes with mail carriers and slow down mail-delivery times but also jeopardize private and nonprofit approaches to senior care. The homebound elderly certainly deserve our help and compassion, but America’s mail carrier is not up to the task.
Writing for the Los Angeles Times, physician and Kaiser Health News editor in chief Elisabeth Rosenthal suggests having “letter carriers spend less time on delivering mail.” “Instead,” she adds, “include in their responsibilities home visits and basic health checks on the growing population of frail and elderly.” As Rosenthal points out, the USPS’s inspector general (IG) has called on the agency to become more involved in health and wellness initiatives.
Some ideas discussed in the IG report make perfect sense and are already being implemented to some extent. Take, for example, the “Carrier Alert” program, which currently tasks USPS workers with reporting changes in behavior and mail-collection patterns of enrolled individuals. Letter carriers can report the buildup of uncollected mail to appropriate local agencies and postal management. The IG suggests expanding this effort nationwide and having the USPS collaborating closely with community organizations, such as Senior Reach, to train mail carriers to take note when something seems off.
But that modest suggestion is a far cry from having mail carriers do home visits and having them “check and record blood pressure, test blood sugar levels in diabetics and even administer pills.” The USPS is already having a difficult time carrying out its basic duties, owing to increasing e-commerce volumes and staffing issues. Expanded employee leave due to the lockdowns has left a shrinking supply of carriers tending to a historically high number of packages in circulation. Delivery times have significantly rebounded but are still slower than pre-2020 levels. Further slowing down the mail by adding health and wellness services to the USPS’s portfolio is a recipe for disaster and will further erode public confidence in the agency.
Rosenthal suggests addressing this issue by cutting down the number of days per week that the USPS delivers mail. “And on the off days,” she said, “presto — we get a new on-the-ground home health workforce.”
Except no one would be happy with that new status quo. The American Postal Workers Union has long fought against reducing delivery days from six to five, baselessly asserting that it would wreak havoc on the mail-delivery system. USPS management has at times pondered reducing the number of delivery days, on the reasonable assumption that five-day delivery could save the agency at least $2 billion per year. But these savings wouldn’t be realized if the USPS were still driving around on Saturdays and management had to invest in a massive new health-care training and hiring campaign.
Sure, the USPS could price those services effectively in a way that allows the agency to recoup these up-front costs. However, America’s mail carrier hardly has the best track record in adequately pricing products and correctly attributing costs. The agency also has some serious issues with screening employees, and the IG has noted, “The current hiring process lacks controls to validate compliance with” needed approvals, investigations, and job-related requirements. In a delicate field such as health care, getting the hiring process right and correcting course on improperly hired employees will not come cheap.
And for all of this trouble, there are far better visitation and check-in services than any hypothetical USPS program could offer. There are quite a few companies, nonprofit organizations, and local and state government agencies that either call or physically check in on seniors living alone. While coverage gaps certainly exist, building up these networks is surely better than converting mail carriers into health-care workers. The funding structure of Medicare tends to incentivize going to the doctors rather than relying on home health care or checkups, and reforming the system can turbocharge these services. These health-care dollars would go a far longer way than USPS home visit “investments.”
The USPS should focus on the mailbox, not the black box that is the U.S. health-care system.
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