Inside many of us lurks the unquenchable urge to shop, the hunger for a better deal. January white sales, cents-off coupons, buy-one-get-one-free, discount cards, cash-back deals: businesses know that consumers will walk a mile to pinch a penny.
Increasingly, that irresistible force is being unleashed on healthcare decisions. Web browsers visit sites like WebMD, Dr. Koop and the Digital Hospital and show up at their doctor's office with printouts of the conditions they think they have and the remedies they think they need. The visionary Overlake Medical Center in Washington State publishes a Healthcare Consumerism Checklist (at left) with information about patient rights, health records policies and on-line quacks. Direct-to-consumer advertising pitches Cialis and Celebrex and Viagra with million-dollar prime time TV commercials. And the U.S. Department of Health and Human Services even runs a HospitalCare analysis web site that compares key acute care indicies just like Yahoo! Shopping compares refrigerators.
The irresistible shopping monster could become a disruptive force on healthcare costs in the U.S. In a 2002 ruling, the Internal Revenue Service opened the way for Consumer-Directed Health Plans (CDHDs), one of the hottest new products in the world of employee benefits. In combination with a conventional health plan with a high deductible, consumers (and, often employers) contribute to tax-free health reimbursement accounts (HRA). The HRAs are used for normal medical expenses, but the money not spent on healthcare this year can be rolled over into following years, creating a growing asset protected from the tax man.
Traditional HMOs control costs by chiseling down invoices and denying payments to doctors through complex bureaucracies that nobody understands. Healthcare consumerism combines the need to stay healthy with the urge to save money and the desire to be in control. It may not be for everybody, but shopping has some real therapeutic possibilities.
I see a lot of press on the ever rising cost of our nations healthcare. Yet we leave the controls squarely in the hands of the government, health insurance companies, and providers. That's the same hands that created the monster. They address the problem with "quality indicators", increased premiums, and ineffective legislation. If "costs" are the problem, then sooner or later you have to focus on the money.
Now we have healthcare "consumerism" that is being rolled out, in a very controlled fashion, by the same ole guard. They are defining consumerism with hospital grades, healthy tips, and physician report cards???
This may be well an good, but as a consumer I want to see "the price", not the providers charge list..."the price". I may not know a good colonoscopy from a bad one, but I sure as heck recognize the difference in price of having one in an outpatient setting (not owned by a hospital) and having the same procedure at the hospital. The insurance companies pay different prices for the same procedure done at different hospitals and outpatient center all in the same geographic area. I'm a consumer....so show me "the price".
While Healthcare Consumerism is still a new term, let the consumer define what it means, not the insurance companies or providers. If costs are a problem, then isn't it appropriate to involve the person consuming the resource in the cost considerations?
You want to see a big difference in the cost of healthcare in this country? Have our Employers implement high deductible plans, supported by HSA's,in the workplace. Then give us the "street prices" of health services in our area.
Now watch the 200 million of us that have jobs, pay taxes, and health insurance, go about our normal and customary course of consuming healthcare. With bigger personal responsibility (out of pocket expense)and armed with "the price" to use as one of our considerations...I feel very confident that my fellow Americans can remove a significant amount of cost out of the system. High Deductible plans offer a lower premiums, a consumer shopped claim is a cheaper claim for the insurance company, and lower costs allows more of our citizens to get coverage. Make consumerism real....show me the money...give us "the price"...after all we're paying the premium.
JFR
Posted by: JFRock | April 21, 2008 at 06:48 PM
JFR:
Good point: price comparison is crucial. I love the way MinuteClinic posts the prices for procedures on the walls of their clinics:
http://in3.typepad.com/hnbic/2006/02/minuteclinic_re.html
Posted by: JackPowers | April 23, 2008 at 01:17 PM
The shopping monster???? Your slant sounds like anything but saving actual money for the paying consumer.
Here's the deal. It's now known by most consumers that our/your insurance company has negotiated different prices with the different providers in our/your area for the same procedure. That means if you live in Averagetown, America and their are two hospitals in the area and you need a colonoscopy. Your insurance company has negotiated one price at hospital A and another price at hospital B for the same colonoscopy. May I see the two negotiated prices, I may want to save my healthplan some money....in an effort to keep my premium costs from continuing to skyrocket.
I contend that all the hoopla about quality indicator's and outcome statistic's are squarely the responsibility of insurance companies and hospitals. That's what I, as a consumer, am paying for. My Gosh, at today's healthcare prices should I not EXPECT at the very least that I going to get a compotent clinician(properly credentialed by the hospital) and a good result. Or is my insurance company going to pay for services that don't make me better?
Now, if we are going to do something about rising healthcae cost....shouldn't we talk about the price charged to the consumer?
I bet if myself, as well as the other 200 million of us that health insurance, were provided the "negotiated price" from our insurance companies to use in making our healthcare decisions, it would dramatically flatten the rise in healthcare cost.
It is ridiculous to say we have to do something about healthcare costs, and then don't show the paying consumer what the prices are. Do you buy a house, a car or even a TV without looking at the price????? Healthcare is NO different. Show the paying consumer the "negotiated price" and we will show you, in the healthcare provider and insurance industry, how to tighten your belts like you're asking my family to do.
Posted by: Jame F. Rock | September 22, 2008 at 04:53 PM