The American economy while battered, shaken, and plagued by staggering debt from wasteful government spending continues to remain relatively safe to many in the business world. Conventional American medicine boasts amazing technology and innovation but it remains unlike any other segment of the economy as most Americans would currently agree it’s a broken system.
It has been difficult or even impossible for Americans to become educated healthcare consumers. After all, the time-tested adage that you get what you pay for just doesn’t hold true in American conventional medicine. In American medicine more money does not equal more care and certainly does equal better care. There are the complicating factors of complications, side effects, nocosomial (caused by the system itself), along with its very-own terminology. Myocardial infarction-why can’t they just say heart attack? Essential hypertension-why can’t they tell you it’s high blood pressure caused by unknown reasons? And the lab tests, why was a cholesterol reading of 300 mg% normal until just a few years ago and now it’s the lower, the better. Then there is the disconnect between the fact that the patient is in charge and even though they may be footing the bill personally, their money directly or indirectly is paying for the services they receive. We would indignantly refuse to pay for complications when our car is serviced but we fail to be outraged if we are charged and our insurance pays for hospital-acquired infections, complications, drug interactions, and the like.
Healthcare reform took a huge step forward when the Bush administration announced Medicare would no longer pay for mistakes caused by the system. We would not pay our accountant or attorney for mistakes they made, would we? The current voter mood may take this further as their outrage for wasteful government spending is affected elections across the country.
Comparison shopping is slowly coming to medicine. The Cleveland Clinic has joined with venture capitalists in a venture, Castlight Health, to build a search engine for health care prices. The supermarket chain, Safeway, has already signed on as its first customer. Others are also joining that effort to provide Americans this basic consumer information including the New Hampshire state government, Aetna, and a start-up from Tennessee calling Change: healthcare, among others. Click here to read further. Several years ago The Wall Street Journal revealed the prices of MRI scans and the eye-opening information that more expensive scans were not better scans. In fact, some of the least expensive scans were of the highest quality. We can only imagine what else we may learn if we clearly understand the cost and the quality of the service. The difference between what labs charge for blood tests and what diagnostic centers charge for scans and procedures can be profound. It is only a matter of time before consumers couple that with quality information. Am I getting the best price and am I getting the best quality? These are two questions most American healthcare consumers never even knew to ask.
Mercer, a human resources consulting firm, recently published a study that found that those on high-deductible insurance plans spend less. It’s basic consumerism 101. If the money is coming out of your pocket, you want to know the price of the service and are inclined to shop around for the best price and want to be sure you are getting the best care for the money you spend.
Consider the situation Castlight Health has revealed to Safeway employees. Safeway pays their employees up to $1200 for preventive colonoscopies. In one location, the price can range from $500 up to $3000 for colonoscopies. Even the same doctor charges different fees among different hospitals where they perform the colonoscopy. That would not be tolerated in a consumer-driven economy.
Now, it appears Congress is also a less than educated healthcare consumer. Healthcare reform was sold to Congress by the current administration to eliminate wasteful spending. However, the data cited from the Dartmouth Atlas of Healthcare illustrated the difference Medicare paid for the same procedure in different areas of the country. Congress interpreted the data that more money equaled better care and less money equaled poor care. However, it has not been acknowledged that this is NOT the case. Click here to read further http://www.nytimes.com/2010/06/03/business/03dartmouth.html. And more medical procedures does not equate to better care. More medical procedures are sometimes both wasteful and potentially harmful.
Undoubtedly it will take years for government, business, and consumers to get the message. However, given the warp speed with which changes in technology such as cell-phones emerge, come on the market, and eclipse more expensive outdated technology, we can only imagine when costs are shifted primarily to consumers, how rapidly the medical system will change to be more in line what we find with any commodity purchased by the consumer.
Physician offices are also increasingly cost shifting to consumers. Click here to read further. While consumers now complain, they will ultimately find ways to spend their dollars more wisely for healthcare. Integrative physicians’ offices are ahead of this curve as most of these offices are private pay, that is, consumers pay out of pocket for care in these settings.
The ultimate control of healthcare costs outside emergencies and accidents is increasingly equated in consumers’ minds to their lifestyle choices. If we consider the costs relating to heart disease, diabetes, and even many forms of cancer, many consumers already acknowledge if they make wiser lifestyle choices, they can even affect genetic expression and dramatically reduce or eliminate their risk of these chronic diseases that have high price-tags. Companies preceded consumers in this aspect of healthcare costs and many now say “no thanks” to hiring those who smoke or engage in other risky behavior. If visible role models like former AK-Governor Mike Huckabee demonstrate how their lifestyle choices reversed serious disease (in Governor Huckabee’s case, he reversed type II diabetes with eating and exercise changes), consumers will pay attention particularly if the consequences of their own lifestyle adversely affects their pocketbook. The natural products industry, integrative medical doctors, and medical spas are all examples of how consumers will spend to increase their quality of life.
The revolution in American medicine is well under way. It is possible the U.S. will no longer lead in dollars spent on healthcare but lead in the efficiency and outcome of the healthcare system.
Deborah A. Ray, MT (ASCP)