More about Money
HSAs, MSAs, HDHI, Flex Spending, etc. are all designed to make paying for healthcare easier for consumers, AND make consumers more conscious of costs. These are coupled with efforts to provide information to consumers on the “quality” of providers and thus facilitate decisions. Problem is, the ivory tower concepts of “quality” (conformance to standards) isn’t quite in line with consumer concepts. For most consumers, technical quality is assumed. (That may not be justified, but I think it is true.) They depend on accrediting organizations, government oversight, and hospital boards to assure satisfactory technical performance. They want to compare costs and service quality. As John points out, “costs” means out of pocket costs. Service includes things like wait time, information sharing, free parking, friendly staff, clean facility, etc. You can’t find this sort of thing except by asking friends and neighbors. That’s one reason patients don’t use the sites available to compare “conformance to standards.” One argument against publishing prices and fostering cost competition is that it would diminish hospitals’ ability to cost shift--overcharging in one area to compensate for losses in another. But this is one of the main reasons healthcare costs so much--it is expensive. In other words, institutions are allowed to charge too much, because there is no price pressure. Which brings us back to efficiency. If you are a provider of an expensive service, and a competitor offers it for 30% less, what do you do? If you want to maintain your margin and your profit, you have to become more efficient or be priced out of the market. It works in business, it can work in the business of healthcare, but we need to become a lot more transparent to make this work. Consumers need more information on prices and they need the power to make purchase decisions. Then costs will decrease.
