Saturday, March 11, 2017

Patient-Centered, Market-Driven?

Not so much.

To address this lack of price transparency,  the Centers for Medicare and Medicaid Services (CMS) during the Obama administration launched a public database of charges by doctors, hospitals, drug companies and other providers.  You can find it here. If you are a professional researcher, you might be able to figure out which hospital in Minneapolis has the lowest posted price for a heart transplant or any of 100 other of the most common procedures.

If Republicans really wanted patients to take more responsibility for their health care, they would fix all that — fix it by insisting that doctors, hospitals, pharmacies and other providers make all their prices for all classes of customers readily available at the front desk and on their websites. But if you look through the 123 pages of the Republicans’ American Health Care Act that was rammed through two House committees this week before anyone could digest it, there’s nothing about any of that.

Nor is any mention of quality metrics. Obama’s Affordable Care Act included a big push for the government to do what is known as “outcomes research,” using millions of patient records to determine what operations, what drugs, what tests were most effective in treating various conditions. But at the insistence of Republicans, researchers cannot consider price in their analysis, making it impossible to determine which offers the best value. The Republican bill leaves this prohibition in place. What it does do, however, is to repeal the small tax on group health insurance that funds outcomes research.

Yeah, I think it's more about giving rich folks tax breaks. 


  1. In our system your employer has nothing whatsoever to do with your health insurance.
    Imagine my astonishment, from that perspective, at reading this in the Washington Post:

    "Employers could impose hefty penalties on employees who decline to participate in genetic testing as part of workplace wellness programs if a bill approved by a U.S. House committee this week becomes law."

  2. I believe our only hope is that this debacle becomes such a shit show that we end up getting universal health care out of it. Have no idea how that's going to work. The greater chance is of having no insurance probably.