Reducing Costs
It can be done. At one time, preoperative testing prior to outpatient surgery was a major expense. As formal studies began showing that most of this was without value, we decided that, with few exceptions, we would not require any tests. We weren’t so much concerned with cost to the insurance company as with the time and trouble for us on the day of surgery. The second most common cause for starting surgery late is looking for a lab test. If you order a test, you have to look at the result, and those aren’t always easy to find. Some surgeons persisted in ordering some tests, and then, an interesting thing happened: BC/BS decided that if we didn’t require the tests, they wouldn’t pay for them. Next time a test was ordered, the patient got the bill. And the patient complained to the surgeon. And the surgeon stopped ordering the test. And they lived happily ever after.
One area where price competition currently exists in healthcare is cosmetic surgery. Want a tummy tuck? You can shop for price, and it’s a package deal--one price includes everything. A new plastic surgeon came to our town, and we wanted him to use our facility. He was in price competition with other surgeons, and we had to negotiate with him for the costs of our operating room and anesthesia services.
Patient centered healthcare would extend this principle to all of healthcare. However, this would require a lot more price transparency than currently exists. You can find out the cost for a tummy tuck, but not for a cholecystectomy. (At least not in a hospital.)
There is, of course, the quality thing, and that requires transparency also--and diligence by the patient. Story in Saturday’s Washington Post about women in Hollywood having injections by a guy who never went to medical school. Incredible what the right personality will do. Someday, he may be president.
One area where price competition currently exists in healthcare is cosmetic surgery. Want a tummy tuck? You can shop for price, and it’s a package deal--one price includes everything. A new plastic surgeon came to our town, and we wanted him to use our facility. He was in price competition with other surgeons, and we had to negotiate with him for the costs of our operating room and anesthesia services.
Patient centered healthcare would extend this principle to all of healthcare. However, this would require a lot more price transparency than currently exists. You can find out the cost for a tummy tuck, but not for a cholecystectomy. (At least not in a hospital.)
There is, of course, the quality thing, and that requires transparency also--and diligence by the patient. Story in Saturday’s Washington Post about women in Hollywood having injections by a guy who never went to medical school. Incredible what the right personality will do. Someday, he may be president.
