A Native American woman had hoped to renew her health care coverage at the University of New Mexico Hospital last year. Showing up at one office for an appointment, the woman was directed and then re-directed to multiple offices until she was back at the first office where she was told she had missed her appointment and needed to reschedule. “Six weeks later she is in need of medical care but is delaying it because she has not been able to renew her UNM Care coverage,” the authors of the memo wrote. The June 17, 2009 memo opens a small window into the sometime Byzantine world of health care, especially on the insurance – or payment – side at New Mexico’s busiest hospital.