Read this, an article in Newsweek about the lack of evidence being used in cancer care, something I have long complained about. We don't know who the best doctors and hospitals are, because they are not required to share their outcomes.
How, then, does a patient with an HSA decide upon the most cost effective treatment? Who besides the government can compel outcomes reporting and research to decide what works?
Is having more Oscar contenders going to ensure that more small films win?
What ever happened to the five cent cigar?
And why can't anybody beat the Yankees?
I think the reason this information is not made public and easily accessible is that we are not the current consumers of health care...health insurers are. If I get cancer, my health insurer is not NEARLY as concerned about where I get my treatment as I am. So, there's no pressure for it.
ReplyDeleteIf health reform moved us towards HSAs, health providers would suddenly have to fight for customers. There would be REAL pressure to provide information. And a huge opportunity for an enterprising person to create an online service aggregating it. I would most definitely pay for that.
As long as insurers are the customers and not us, there's no incentive for them to share this information.
In other news...I'm not loving more oscar contenders.
I agree with Jeanne totally. Our insurers are far more concerned with getting off cheap than getting us cured. We cost less dead... of course they stop getting our money too, so you would think they would care quite a bit more.
ReplyDeleteDo people still watch the Oscars?
I would semi agree with you Jeanne-your insurance company cares about where you get your treatment-they just don't care about the QUALITY of treatment you get.
ReplyDeleteYou may be right-maybe widespread HSAs would force more information out of providers. But providers oppose disclosure, I think, because they fear liability, and because they are afraid they might not measure up.
But overall, one of the arguments we seem to keep falling into is "why can't we just let market forces work on health care"? The premise underlying HSAs is that the consumer can spend money better than anyone else can.
This article indicates we can't do that in health care- we don't know which providers are of high quality.
Ananda girl, thanks for the vote of confidence! I do watch the Oscars with champagne every year. My husband and I do ballots ahead of time and compete to see who can call the most winners. Totally lame, but fun nonetheless.
ReplyDeleteMichael, I agree. Insurers do fear disclosures because of liability. The cost of malpractice insurance is insane. Laws do need to be made protecting health care providers from frivilous lawsuits.
Undoubtedly it would be in the providers' best interests to keep the current insurance-based system. There would continue to be less pressure to "measure up." I suspect that is exactly why the current health care "reform" proposals all center around maintaining that system.
You are right that for HSAs to work, the consumer would have to have access to a lot more information about health care. You are right that they don't have it now. That doesn't mean it will alwasy be thus.
You claim the Newsweek article says we "can't" do that in healthcare. I disagree. The way I read the article, we "don't" currently provide the information. The information is out there, and laws could be made to require public disclosure.
Just because we don't do it now, doesn't mean we couldn't in the future.
The information does exist, yes. (Well, in some cases they might not be collecting it, but in principle, it probably does.)
ReplyDeleteBut my point is that HSAs don't work without high quality information with which to evaluate providers-and, as long as providers are able to block disclosure of their outcomes, you can't get this information.
Then we are agreed. The information is necessary for HSAs to work. It isn't readily available now. If we went down the road of HSAs, laws and regulations would have to be put in place to force providers to make the information public. Actually, it's probably a darn good idea on its own merits, with or without a move towards HSAs.
ReplyDeleteOn to the next debate...
"And why can't anybody beat the Yankees?"
ReplyDeleteI've said it before and I've said it again. Often, but not always, it seems like that for whatever reason, the Yankees are like they are the lone member of a superior league, and are slumming it playing the other teams.
Time to give them a "lifetime achievement trophy" so the team can be retired from baseball, and the mortal teams can be left along to compete for their championships without the Yankees winning again and again and again.
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Jeanne said: "Michael, I agree. Insurers do fear disclosures because of liability. The cost of malpractice insurance is insane. Laws do need to be made protecting health care providers from frivilous lawsuits."
I've seen the cost of this situation as ranging from $50 to $500 billion dollars. In this, the Dems are clearly acting with an eye toward the money they get from special interests, and against the public interest.
Reforming this situation and getting rid of the problem is a no-brainer. One of the many simple and profound reforms that can greatly improve healthcare without the "need" for things like the public option.