healthcare industry

When you’re shopping for something, sometimes price is the only consideration. Yet think about the times when price matters, but you’ve already determined the only brand or brands you’re interested in buying.

Let’s say you’re buying a car. You’ve done plenty of research, using the criteria that are important to you. Fuel economy, vehicle safety statistics, passenger/cargo capacity, style, color – your vehicle-value-determining checklist. Only after you’ve built that list will you start to hone in on price, shopping around to find the dealers that have what you want in your price range. Value is only fully visible when you know what  you’re getting for the price.

Even in something as simple as grocery shopping, price isn’t always the #1 driver of purchase decisions. Sure, for some things generic Brand X at rock-bottom price is the way to go … on things like shop towels. However, ask any Coupon Queen what her quest is all about, and she’ll tell you that it’s about brands, then it’s about price. She’s not clipping coupons for generics, unless it’s a store brand that meets her quality metrics.

Price is important. Value is critical.

In the “how much is that?” campaign in healthcare, we’re as concerned about quality as we are about price. In healthcare there are quality metrics that far outstrip those for consumer products, but many of those healthcare quality metrics have been hard for consumers – patients – to find and use in assessing healthcare value. That’s changing with the rising availability of quality metrics like the Hospital Safety Scores from The Leapfrog Group released at the end of November. The US Department of Health & Human Services’s Agency for Healthcare Research and Quality – that’s a mouthful (and a massive amount of information on one site), let’s stick with HHS’s AHRQ, shall we? – has comprehensive info on healthcare quality and how to use it, and you paid for every byte with your tax dollars.

Here’s the challenge: start educating yourself about price AND quality when you’re buying healthcare services. Cruise the AHRQ information. Dive into the Hospital Safety Scores if you’re slated for a hospitalization. Ask “how much is that?” throughout the process. You might not get answers every time, but the more you ask, the faster the system will shift toward price transparency.

It’s up to us. Let’s roll.

I’ve asked this question frequently over the years, starting in the ’80s, continuing to today … and I’ll keep it up until someone realizes that it’s a failed paradigm.

What we have here, kidz, is what happens when a society decides that socialism is anathema, but doesn’t empower and educate its citizens about how to take responsibility for themselves in ways that will keep them healthy, productive community members.

Business started picking up the tab for healthcare during World War II, when stiff wage controls made it impossible for defense plants to give their employees raises. In place of more money, they started to pay for health insurance – which state and federal government were more than happy to turn into mandated employee benefits over the next 20 years.

What happened then was predictable: three generations have been out of touch with the true cost of healthcare, and the true cost of their choices about their health. If you’re a good little American consumer, you do whatever your television tells you to do: eat this. Buy that. Otherwise the terrorists win!

Three generations of disconnection from the real costs of our medical care have delivered us an epidemic of obesity – thanks to plentiful empty calories, courtesy of agri-business, and our willingness to beach ourselves on our sofas, in our SUVs, or at our computers, the better to receive more messages about what we should buy and eat.

Health insurance costs have skyrocketed as we’ve become a nation of couch potatoes. Companies are scaling back their employee health benefits as those costs continue to rise, putting more and more people in the un-insured or under-insured bucket. Is that rise in healthcare costs, which in turn drives higher premiums, combining with the federal mandate that all companies offer employees health insurance or face the wrath of Khan, er, the feds the real “job killer”? I think so.

Here’s a suggestion: sell health insurance like auto, home, and life insurance are sold. Put consumers in charge of shopping for, and purchasing, their own insurance. Let business help their employees, if they choose to do so, as a true benefit rather than a mandate. Help every consumer set up a Health Savings Account for their healthcare expenses. And stop the state-by-state divvy-up that lets health insurers essentially gerrymander the health insurance marketplace.

Put consumers fully in charge of their insurance, and their care. Turn the health insurance market into a car-insurance model. People can buy minimum levels of insurance, and assume the risk of that choice. They can opt out completely, and assume all the risk for their healthcare costs. Make it a true marketplace, rather than the giant mess that we currently call health insurance. Employers are certainly able to help their employees with HSA deductions and matching contributions; smart companies will help their teams figure out managing and negotiating for insurance as a group. But they shouldn’t be expected to foot the bill.

Radical? Perhaps. Necessary? I’d say it’s essential.

Until we’re put in touch with the costs of our healthcare, we won’t be encouraged/empowered to take control of our health. As long as we’re using other people’s money to pay for healthcare, we’re stuck where we are.

Which is a very bad place to be.

That’s my story, and I’m stickin’  to it …