So
Many Choices, So Little Information!
Those of us who believe in education know that smart,
successful shoppers are made, not born. Critical to our
ability to make wise decisions is the availability of
useful tools. In the areas of health and medicine, such
tools don't yet exist. Whether they ever will is an open
question.
When you go to the supermarket, you're guided by ads
featuring prices of the specials. Tags on the shelves
tell the price of everything. And for those concerned
about value, there are simple nutrition folders that
allow one to contrast the value of bean sprouts with
lima beans.
|
|
Jessie
Gruman
President
and Executive Director
Center for the
Advancement of Health
|
Supermarkets are
not unique. Comparable guidance is available for
those who spend money on airline tickets, restaurant
meals or cars. In fact, there are more than a few
successful businesses that provide us with the
tools we need to shop wisely.
Those who lack time, mobility or patience may hire
a more sophisticated agent -- ranging from personal
shoppers to financial planners -- to make some
preliminary decisions for them.
In the health arena, patients are increasingly
told to behave as shoppers and decide which health
plans, doctors, drugs and therapeutic strategies
they'll rely on. But the comparative information
that could help them out, for the most part, does
not exist.
Much has been said, but very little done to create
or provide tools. There is a wealth of health advice
available on the Web, including helpful and disinterested
information on most conditions, but separating
the wheat from the commercial chaff is an ongoing
challenge. You can learn the value of some things,
but the price of nothing.
Advice that you can enhance your safety by purchasing
a car with side airbags is not the same as providing
you with a list of which autos offer this feature
and at what price.
Markets are powerful and useful institutions,
often far superior to alternatives. The ones that
work best also require robust infrastructures.
America's stock exchanges work partly because the
rules are clear and there's a level of transparency
enforced by government agencies to assure that
consumers have access to the information required
to make decisions that aren't inherently disadvantageous
to them.
One of the lessons of the post-Soviet era involves
the ongoing efforts to recreate market economies
in the former satellite nations in Central Europe.
Simply razing the Berlin Wall and allowing free
elections weren't adequate to jump-start market
economies.
Seers have long told us that upgrading information
technology is a prerequisite to reforming America's
health system. It hasn't happened, partly because
no one has figured out how those who make the needed
investments can receive the return. If my insurance
company makes it easier for me to file a claim,
that won't necessarily save them any money. I might
file more claims if the task were simpler. If a
local doctor or hospital posted their rates, it
might drive patients away, or discourage referrals
from those who were offended by such a commercial
act. From neither perspective is transparency a
good business plan.
The Economist reports that financial firms here
spend about 8 percent of their revenue, or $200
billion annually on such investments. The health
care industry spends $26 billion, which is just
over 4 percent of what it receives. Once again,
you get what you pay for.
There are few incentives and scant political
will for the big investment required to provide
the quality and cost information infrastructure
a consumer-driven health market demands.
Meanwhile, sick and well Americans are daily
called on to make more health choices. Where's
the information that will allow them to make
good ones? Something is wrong with this picture. |
