By John Ballard
I'm encouraged to report that a national conversation about health care costs are finally going mainstream. ABC News, which has also done excellent journalism about health care in the past, put this piece up last night.
Those following the discussion may also be interested in the following links.
?By now readers here already know about ALEC (American Legislative Exchange Council), a well-funded outfit now finally under scrutiny from authorities, and its super-Conservative agendas. In ALEC, �Shadowy Group� Behind State Efforts To Sabotage Health Reform Faces Heat From IRS Naomi Freundlich tracks the latest ways that group continues to attack health care reforms, one of many items on an evil punch-list.
In terms of health care, Wendell Potter, a former health care executive and CMD�s Senior Fellow on Health Care, writes in The Nation, �As its archive reveals, ALEC has been at work for more than a decade on what amounts to a comprehensive wish list for insurers: from turning over the Medicare and Medicaid programs to them�assuring them a vast new stream of revenue�to letting insurers continue marketing substandard yet highly profitable policies while giving them protection from litigation.� This includes model bills that allow insurers to sell products across state lines�including �junk insurance� and very high-deductible plans�even though they may not meet the standards of state insurance commissions.
?Consumer-Driven Medicine�s Fatal Flaw
Merrill Goozner, well-known writer and journalist specializing in health care matters, lays out the pricing issue (rather the lack of pricing information) in this post at The Health Care Blog.
In a week it has collected a scrappy bunch of comments, mostly from insurance and other industry insiders (not many actual consumers go here for information), arguing among themselves. For a reader with patience, willing to overlook a lot of sarcasm and back-biting, one can catch a glimpse of the behind the scenes obfuscation involving providers, group insurers, TPAs (third party administrators) and insurance plans, mainly high deductible variety, being marketed for consumers with Health Savings Accounts (or Medical Savings Accounts -- I'm not sure which... they are not the same but since I'm on Medicare it isn't an issue that intrests me enough to do that homework.)
Where Are The Prices?
Employers are already moving in the direction of giving consumers �more skin in the game,� according to a recent survey by the Employee Benefits Research Institute. One in five Americans are already in high-deductible insurance plans, an all-time high, even though this approach is leading many to skimp on preventive services that could avoid higher health care costs down the road.
Unfortunately for the architects of such proposals, there�s a crucial element missing from their proposals, something that is necessary to make any market work: accurate and easily accessible price information for consumers. Have you ever walked into a doctor�s office and seen a price posted for all the tests, products or procedures that might be offered during your visit? At the hospital? Ever seen a price list at the local pharmacy?
The problem of price opacity in health care is not easily solved. Health care providers are more like airlines than the local Best Buy or Macy�s. They charge different patients different prices depending on who insures them. The uninsured pay the highest prices, the equivalent of a hotel rack rate.
I think this video has been up before. But in any case it's a good time to run it again.