Insight, analysis & opinion from Joe Paduda
The good folks at the California Healthcare Foundation explain why more information does not necessarily equal better consumerism.
Their main point? Consumers’ decision making processes are not linear, simple, or straightforward; the deep complexities of the health care decision-making process do not lend themselves to simple metrics and ranking systems, yet that’s what consumers like to use.
The largest health plan trade group wants to form a new agency to “compare the cost and effectiveness of medical treatments as part of a series of recommendations to reduce health care costs.” (California HealthLine from CongressDaily) At first blush that’s pretty similar to what the Agency for Health Care Research and Quality is doing today.
As part of a very good (defined as substantive, open-minded, and comprehensive) discussion on health care reform options going on at TPMCafe, Jonathan Cohn notes:
“a lot of these people don’t understand how precarious their current situation is – because they don’t realize how easily they could lose coverage or the extent to which their insurance might not cover their bills.(emphasis is mine) (Indeed, that’s the whole point of my book.) But for now, anyway, that’s what they think. And if you start telling them you’re going to change their health insurance – even for an alternative as well-liked as Medicare – a lot of them will get skittish.”
That’s true. But at some point, enough of “those people” who lose coverage or go broke paying bills will decide to do something about it. And that “something” doesn’t have to be national; I’m of the opinion that there will be real reform in more than one state years before we do something nationally.
But which ones, and why them?
Richard Eskow has a great synopsis of the historical roots of capitation over at Sentinel Effect – brief, entertaining, and well worth the click-thru.
An effort in Connecticut to implement a single payer, universal coverage program is just about dead, after the state’s Office of Fiscal Analysis determined it would cost as much as the entire state budget.
Politicians were shocked by the estimated total cost, which ranged from $12 billion to $18 billion.
I’m shocked that they were shocked.
TPMCafe has an ongoing debate amongst health policy types about the pros and cons of single payer. There’s an all-star cast, and your lunch hour is coming up, and you’re kind of wondering why single payer is good/bad…
I’m having a tough time getting mad at United Healthcare. The huge managed care company is under fire for penalizing docs who use any lab other than UHC’s preferred partner, LabCorp. The AMA, regulators, individual physicians, and a few consumer groups are all screaming about UHC’s heavy-handed, dictatorial infringement on their right to practice medicine.
They’ve got it all wrong.
What gets lost in the healthcare debate is the impact of our dysfunctional system on individuals and families. Jon Cohn of The New Republic and elsewhere has gone a long way to personalizing the health care mess in his new book, “Sick”.
Jon’s also leading a debate on the topic at TPM. Several health care types including your author are arguing to and fro, while others are keeping us honest.
Consumer directed health plans will make all of us better users of the health care system. We’ll shop for price, be careful about what procedures we get from whom for how much how often. We’ll bargain, examine data, and carefully compare providers.
And as a result, we’ll all save a bundle, and the US health care system to boot.
Sort of.
The fine may be a million bucks, but the PR damage is much worse.