Transparency
Writing for the Commonwealth Fund, Karen Davis and Sara Collins discuss obfuscation in healthcare. Want to know how much your appendectomy cost? It’s really hard to tell. Hospitals can take a year or more to assemble all the charges, and insurance companies don’t pay charges anyway. Davis and Collins think more sunlight on costs could have positive effects. Providers would have a benchmark, insurance companies would be able to “reward quality and efficiency” (no clues on what that means), and patients could make “informed choices.” However, they go on to say that it wouldn’t really work, because “healthcare is not a homogeneous commodity” and “patients will never have as much information about the care they need as the physicians who care for them.” Wow! talk about paternalism. “You can’t understand these things, but trust me. I’ll take care of you.” Somehow, I don’t think so. The same statements could be made about almost any purchase in this highly technical world. Anyone know the compression ratio in their car? Can you tell me the difference between a USB port and a firewire port on your computer? But somehow, consumers manage to make choices about cars and computers. Perhaps the same could be true in healthcare.
In criticizing patient cost-sharing, they correctly point out that Americans already pay a larger share of healthcare cost than other countries. Another study found that patients in high-deductible plans were less satisfied and more likely to forgo needed care than those with traditional insurance. Well, duh! They’re unhappy because they suddenly realize healthcare costs money. Their money. And who decides what care is “needed?” They patients obviously decided it wasn’t, and their providers failed to convince them otherwise. Funny how that works. It’s called a free market, where consumers make choices--something heretofore absent in healthcare.
Transparency is a chicken and egg thing. Choice requires information, but no one will provide information unless patients have choice. Today, we have neither. Where do we start?
In criticizing patient cost-sharing, they correctly point out that Americans already pay a larger share of healthcare cost than other countries. Another study found that patients in high-deductible plans were less satisfied and more likely to forgo needed care than those with traditional insurance. Well, duh! They’re unhappy because they suddenly realize healthcare costs money. Their money. And who decides what care is “needed?” They patients obviously decided it wasn’t, and their providers failed to convince them otherwise. Funny how that works. It’s called a free market, where consumers make choices--something heretofore absent in healthcare.
Transparency is a chicken and egg thing. Choice requires information, but no one will provide information unless patients have choice. Today, we have neither. Where do we start?
Comments
Very interesting blog. I especially took note of the point you make about our informed decisions on other technologically saavy purchases. Studies do show that when patients feel that they have been fully informed, their procedures are more successful and error is decreased.
I think it gets back to the basics of treating your fellow human being with dignity and compassion, and eliminating the paternalism as you say.
Posted by: Andrew Hillig | May 10, 2006 09:37 AM
Yes, Andrew. Funny how that works. Customers do better when they participate in the process. That applies to industries outside of healthcare also.
Posted by: Robert Burney MD | May 16, 2006 09:39 PM