Last week there was a thought-provoking opinion piece in the New York Times by Tina Rosenberg that tied together pricing transparency, cost reductions, the power of PPO’s and hospital systems, self-insurance and patient empowerment. Quite a feat.
Here’s how she tees up her article, entitled “The Cure for the $1,000 Toothbrush”:
“Here is a basic fact of health care in the United States: Doctors and hospitals know what they charge, but patients don’t know what they pay. As in any market, when one side has no information, that side loses: price secrecy is a major reason medical bills are so high. … We know about these bills, which hit us directly. What most people don’t know, because the costs are hidden, is that the same imbalance exists with insurance. The employers and employees who buy health coverage have delegated vigilance over health care costs to insurers — but insurers, for the most part, have gone AWOL.”
Rosenberg made a compelling case for the dire need and growing market-driven demand for transparency in pricing, and how not only is it the right thing to do, but it leads to cost savings. The article calls out the relevance of health plans under the traditional pre-reform model of health insurance, and sheds a rather garish light on the power of PPO’s and hospital systems and their traditional contracting and pricing models.
My final takeaway is that all of Rosenberg’s points lead us to the threshold of the inevitable: the awakening of a sleeping giant in the marketplace today – the patient.
I really identified with Rosenberg’s article because a lot of what she had to say reflects the conversations I’ve been having throughout the country with health plan and hospital executives for some time now.
Times are rapidly changing in health care; particularly in the realm of surgeries and especially with regard to high cost implants (40% of all surgeries contain an implant; includes tissues, clips, anchors, etc.); there’s a new way of thinking that allows patients, surgeons, hospitals, ASCs, health plans and device manufacturers to win. We just have to detach from the old ways of doing things, because they aren’t going to survive in a post reform marketplace.
Click here to read Rosenberg’s entire article.