Transparency and Choice Could Radically Reshape Healthcare

  1. The New York Times on the consumerist revolution in retailing:

    Pricing has always been a tug of war between retailer and
    shopper, with the retailer having more muscle. No more. Thanks to the
    Internet and shopping comparison apps, price-wise shoppers are haggling.
    Mr. Vineburgh, a real estate agent, has a closet full of haggled items,
    including shirts from Jos. A. Bank and the Brooks Brothers outlet.

    If retailers balk, some shoppers walk; there is always Amazon and
    eBay. The shifting balance of power has many stores scrambling for
    pricing strategies that get beyond the time-worn cycle of markups and
    discounts — and still make them money.

    Of course, there is no reason why this sort of revolution of
    transparency and choice couldn’t radically reshape the American
    healthcare system, as well.

    Harvard University’s Regina Herzlinger has
    been the leading proponent of just such a transformation where patients
    become empowered consumers. Here’s a good summary of her approach, via BusinessWeek:

    – Consumers tailor their own health-care coverage, navigating in a national insurance market.

    – Small, disease-specific hospitals care for patients who don’t need all the services offered by medical centers.

    – A national database contains the prices and outcomes for procedures
    at every hospital and clinic, so consumers can make informed choices.

    – Individuals get generous tax breaks to buy their own insurance, with subsidies for those with low incomes. Here is where I part ways with Regina Herzilinger. Why must everything have a GOVERNMENT connection or controlling interest. If we all got to keep more of our money by having lower taxes rather than a punitive progressive tax we could afford to take care of the things we need to take care of. It is this constant government intervention into our lives and the marketplace that has gotten everything out of whack.


    Consumers are overwhelmingly interested in the quality of
    their doctor and hospital for their specific needs. So somebody who
    might be planning, let’s say, foot surgery, would be very interested in
    the outcomes achieved by different surgeons in different hospitals in
    doing that procedure on people who share the characteristics of that
    consumer. That’s what people want to know. That information is notable
    for its absence.
    The provider community, the doctor‐hospital community
    understandably is not too eager to provide that kind of information. And
    even when it is provided, it’s provided in a way that is hopelessly
    obscure. …

    This is much like Government run education or for that matter any government agency. We are never allowed to ask for efficiency studies or to look at the work product of these agencies. With teacher tenure we are not even allowed to fire a non-productive teacher or reward a great teacher. Again these are not the marks of a FREE ECONOMY. When the consumer is not given a choice the prices have a tendecy to rise as value and quality decline.

    The providers are not eager to enter into the kind of competition,
    which, like the competition in other markets, rewards better producers
    of goods and services. After all, that’s how Toyota got to be so good.
    It was an obscure Japanese care company, it entered the American market,
    and Consumer Reports and other sites that have very specific
    information said, ‘You know what? Toyota is much better than American
    cars at that time, in the following characteristics.’

    So the providers
    do not want it. The consumers do want it. So how do we get it?

    There is
    only one way, and that is the government must force them to disclose
    this kind of information.
    Again with the GOVERNMENT SOLUTION. NO the best way to get medicine to become competitive is to allow FREE MARKET principles to work. We need the government out of medicine since they reward bad behavior and punish the good. In order for doctors to get federal money they must behave in the ways perscribed by the government. This is not free market capitalism. If people were actually permitted to shop nationally for health care coverage and were able to custom design their own plans and coverages and pick their doctors and hospitals care would improve and costs would decrease because of open and honest competition.

    Under the current healthcare system there is too much GOVERNMENT control and not enough CONSUMER control. Let the buyer beware. And remember the customer is ALWAYS right.

    Now that the government has messed up healthcare for everyone they want to come along and fix it? GIVE ME A BREAK!

    This is a view from the nest. What say you?

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