Today the New York Times released an article detailing the importance of healthcare reform in the upcoming 2008 elections, as well as outlining the various strategies (in very general terms) from candidates on both the right and left of the political spectrum. As the article notes, the proposals from the right and left are markedly different. Proposals from Republicans, “by and large, promise to expand coverage by using a variety of tax incentives to empower consumers to by it themselves, from private insurers.” Democrats also propose “strengthening the private-employer-based system,” but “also see a strong role for government, including…new requirements that individuals obtain insurance and that employeres provide it, along with substantial new government spending to subsidize coverage for people who cannot afford it.”
However it seems that on both the right and the left, candidates are somewhat missing the point. Their proposals do nothing to truly change the healthcare system itself, but rather simply shift the existing burdens in various ways. For example, “new government spending” means using tax dollars (the money has to come from somewhere), which means the burden for healthcare remains on the consumer, albeit in the form of taxes. The “free market approach” taken by many Republicans, on the other hand, is likely to simply encourage the continuance of existing practices, despite the promise of “affordable and portable free-market solutions.” How free-market solutions are magically going to become affordable is not mentioned, probably because it would include a system of tax credits or incentives which, once again, inevitably put the burden of cost on the consumers in the form of taxes.
Yet there is one element that, in combination with either of the above two strategies, could actually change healthcare: insurance and provider information transparency. If providers and insurers were made accountable for their charges, whether in the form of publicly posted rates or through some sort of yearly reports provided to the government for later release, both government subsidized and/or free-market strategies towards health care would be more effective.
Why? First of all, any such publication or availability of this information is likely to breed true competition within the industry. If both consumers and government entities (in the case of providing subsidized healthcare programs) are clearly provided with the costs and benefits of both providers and insurances when choosing healthcare coverage, their decisions will allow them to indirectly put pressure on higher cost and lower benefit providers and insurers. If these providers and/or insurers don’t raise benefits or lower costs, they will be forced out of the market. The biggest difference here is that both consumers and government will no longer be making a “blind” decision, or at best a marginally informed one, they will shop for healthcare just as they do for any other commodity.
Second of all, if such information were to become widely available, it would change the existing burden of cost into a burden of decision making. Whereas before consumers basically paid what they were told, in this case they will have the option to shop around and find the best deal. If they make a bad decision (assuming there is information transparency), it is their fault, but at least they have the option to change that decision. The same goes for government. With information transparency the government would be held accountable for the insurers and providers with which it would contract to provide healthcare. It would be expected that the government should choose providers and insurers with the highest benefit and lowest cost possible, rather than simply choosing blindly.
That being said, it doesn’t seem likely that any of the existing candidates will push for such widespread information transparency. That is one of the driving reasons behind our development of both MedBillManager and FindYourDoc. Until the decision is made to allow consumers to make informed decisions, we at change:healthcare are going to do everything possible to do it anyway.
