Sunday, September 27, 2009

This is Reform -- or at Least Smart

A few weeks ago, Jerry Brady, the former publisher of our regional newspaper penned a rather intelligent editorial on health care -- and one that doesn't point to government as the solution or insurance companies as the enemy. Simply put, before he had elective surgery to repair some tendons in his shoulder, he went shopping.

Or at least had his insurance company go shopping to find the least expensive option for getting the surgery done by a reputable doctor. Surprisingly, his insurer jumped at the opportunity to find good, inexpensive care for him. You'd think more insurance companies would do this, after all, they have a financial investment in the outcome as well. Short story, he found a local doctor at a surgical center who could do the work at a fraction of the cost of local and even regional hospitals.

His conclusion:
Some thought what I did was risky, but, to get costs under control, don't we have to ask questions? In any event, I believe I got the best possible surgery at about half the cost.
I don't know why his approach -- shopping around to find good care at a good price -- should sound so revolutionary. After all, on practically anything else we shop for -- cars, food, gasoline -- we hunt for deals. Why shouldn't we do so with health care?

Because of this attitude, which he describes in his editorial:
When I began asking surgeon's offices about fees, they seemed surprised. "It's all covered by insurance which negotiates actual costs with doctors and hospitals. Why are you asking when it's out of your hands?" was the response I got.
Now, if we were buying a car, say, we wouldn't settle for our auto insurance company negotiating the price with the auto dealer. We don't let a middleman negotiate prices when we're shopping for a new camera or computer. We shop around and learn all we can about what options are out there and then make a buying decision based on our homework.

It ought to be the same with health care, Brady points out.

Michelle and I are getting smarter about this. We've found a local dentist who likes better dealing with cash than with insurers, which is good, since we don't have dental insurance. We feel confident dealing with this dentist -- and his office is even in Sugar City, population 1,200 -- (show me another town of this size with its own dentist). So we need to get smarter with shopping around for other facets of our healthcare.

Maybe this is where government could help -- set up some kind of clearinghouse where people can sort through options to find inexpensive health care options. There are a few private efforts that are starting up, but government could help this avoid a patchwork feel. But at the root of it all, we have to be willing to look around and shop for better health care, rather than take the first thing that comes to us. This could even work with emergency services and emergency care.

Update: Here's some great information on "patients as consumers." Surprising: People didn't make better health choices, but just avoided doctors altogether, when shouldered with mroe of the costs of health care. Yikes.

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