Monday, February 25, 2013

The Health Care Supermarket

Imagine if you went to the supermarket one day and there were no prices on the shelves.  There were no in-store specials, no coupons, no special buys and no limited time offers.  When you went to the store's website to find out about any deals, the weekly ads were replaced by an interview with the Produce Manager talking about how important it is to him that you that you enjoy your broccoli and a testimonial from a woman who ate donuts from the bakery and how good she felt after that.

And when you went to check out, those at the registers wouldn't be able to tell you the price of anything you had put in your cart.  All they could do is record what you wanted and send it off to another person at an office not even in the same building--who would actually figure out your bill.  But even then, you wouldn't know your true costs, because that bill would first go to a third party who would pay--on average--88% of the tab.  You would finally get the bill from your "shopping trip" two or three months later--long after you have eaten the food.

How would that affect the way you shop?  Would you even consider what you purchase anymore?  Would you bother to review the weekly flyers or store websites--putting together a list of what to buy and at what store?  Would items that you used to consider a "luxury"--like steak or lobster or French wine--just become something you put in the cart without any thought--since it "feels good" to eat them, and they are no longer "expensive"?

I thought about this situation Sunday morning when I went shopping for ingredients for my deep-dish, Chicago-style pizza--right after watching George Stephanopolus and the gang on "This Week" debate the cover story in the latest issue of Time magazine on the ever-increasing price of health care.  Of course, the recommendation the reporter makes is that MORE people should be in the Medicare program to "increase the government's buying power" in the market.  While the Conservative talking heads argued for greater patient responsibility in order to increase demand for price competition among providers.

When was the last time you saw a clinic or a hospital advertise price or value?  I'm not talking about emergency care--where time cannot be taken to consider health care choices (that cost will require major tort reform to free doctors from having to order a battery of tests for every patient to "rule out" every possible medical condition in order to avoid "failure to diagnose" lawsuits).  But why don't you ever see ads for Quick Care centers as the "value" alternative to ER visits?  Or surgical centers touting a lower price for their services than competitors?  The only thing we ever hear is how the "experience" at Hospital A or with Doctor Feelgood is all that matters.  The only areas where you do see this is in Dentistry, Optometry and Plastic Surgery--fields where insurance coverage is usually limited and patients pay more out of pocket (and where premiums haven't exploded like they have for standard health coverage).

As long as "price is no object" in medical care, costs will never stop spiraling out of control.  And the more those of us who don't even go to the "supermarket" will have to pay for those who do.

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