Each year, someone, somewhere makes a proclamation about what the next “hot” thing is going to be for that year. It happens in fashion, entertainment, sports and many other categories. But, you rarely hear it in healthcare.
Well, this year, I am going to be the one making the bold prediction. That prediction is that the hot topic in healthcare for 2013 (and for a few years beyond) is going to be “transparency.”
As our healthcare infrastructure evolves and adjusts to the massive changes initiated by the Affordable Healthcare Act, more responsibility is being pushed down to the individual; but the individual doesn’t have all the tools to make informed decisions.
The two biggest drivers in the decision making process are price and quality. And, the two are not necessarily linked. A higher price doesn’t automatically equal better quality.
A great article in the New York Times chronicles a study done by a student at Washington University in St. Louis in getting straightforward pricing for a hip replacement for her “grandmother.” What she found was eye-opening. Prices were all over the board. Some prices differed by a factor of 10; some hospitals gave discounts if asked, others didn’t. Some facilities didn’t even really know how to put a price on such a simple request.
The ability for the consumer to reliably get pricing information from health providers could be the next holy grail in healthcare. So much thought and debate has gone into how to slow down the rising costs of healthcare, but it doesn’t appear that as much thought has gone into increasing competition through price transparency.
I’m convinced this is because there is not a significant organization that is fighting (lobbying) on behalf of the individual healthcare consumer. All of the other major players in the system, doctors, hospitals, insurers, pharma, employers and legislators all have advocacy groups pushing their respective agendas.
Who is fighting for the individual?
When buying a new vehicle, entire industries have developed to tell the consumer the exact price of every aspect of a vehicle. Want to know how much the dealer paid for the vehicle? It’s out there. What rebates are available? It’s out there. Does the dealer get any “backdoor” rebates from the manufacturer? Not hard to find that information.
Now, try to find similar transparency in healthcare. How much is an office visit for a family physician? Good luck with that. What’s the price of lab work when ordered by the doctor? You’ll only get a blank stare or silence if you’re on the phone.
Having price transparency is an absolute requirement as means to help moderate cost increases in the healthcare system. None of the major players in the current system want to see transparency. It will reveal how much padded profit is built into their infrastructure; or, it will transfer too much power to the consumer and disrupt the structure of the system as we know it. Or, it may just expose how messed up the healthcare system is for the individual customer of healthcare in the United States.
Until price transparency is achieved at the individual level, we are just nibbling around the edges of the system. Real healthcare reform requires full price transparency and the ability to measure the quality of care given comparative to the price consumers are asked to pay.
Well, this year, I am going to be the one making the bold prediction. That prediction is that the hot topic in healthcare for 2013 (and for a few years beyond) is going to be “transparency.”
As our healthcare infrastructure evolves and adjusts to the massive changes initiated by the Affordable Healthcare Act, more responsibility is being pushed down to the individual; but the individual doesn’t have all the tools to make informed decisions.
The two biggest drivers in the decision making process are price and quality. And, the two are not necessarily linked. A higher price doesn’t automatically equal better quality.
A great article in the New York Times chronicles a study done by a student at Washington University in St. Louis in getting straightforward pricing for a hip replacement for her “grandmother.” What she found was eye-opening. Prices were all over the board. Some prices differed by a factor of 10; some hospitals gave discounts if asked, others didn’t. Some facilities didn’t even really know how to put a price on such a simple request.
The ability for the consumer to reliably get pricing information from health providers could be the next holy grail in healthcare. So much thought and debate has gone into how to slow down the rising costs of healthcare, but it doesn’t appear that as much thought has gone into increasing competition through price transparency.
I’m convinced this is because there is not a significant organization that is fighting (lobbying) on behalf of the individual healthcare consumer. All of the other major players in the system, doctors, hospitals, insurers, pharma, employers and legislators all have advocacy groups pushing their respective agendas.
Who is fighting for the individual?
When buying a new vehicle, entire industries have developed to tell the consumer the exact price of every aspect of a vehicle. Want to know how much the dealer paid for the vehicle? It’s out there. What rebates are available? It’s out there. Does the dealer get any “backdoor” rebates from the manufacturer? Not hard to find that information.
Now, try to find similar transparency in healthcare. How much is an office visit for a family physician? Good luck with that. What’s the price of lab work when ordered by the doctor? You’ll only get a blank stare or silence if you’re on the phone.
Having price transparency is an absolute requirement as means to help moderate cost increases in the healthcare system. None of the major players in the current system want to see transparency. It will reveal how much padded profit is built into their infrastructure; or, it will transfer too much power to the consumer and disrupt the structure of the system as we know it. Or, it may just expose how messed up the healthcare system is for the individual customer of healthcare in the United States.
Until price transparency is achieved at the individual level, we are just nibbling around the edges of the system. Real healthcare reform requires full price transparency and the ability to measure the quality of care given comparative to the price consumers are asked to pay.
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