We’ve come a long way from the days of the snake oil salesman doctors. We have metrics, proof, real information, process, procedure and healthcare is FAR better as a result.

But I’m reaching saturation point with the quality talk. The only available quality metrics are on the hospitals, but they are comprised of individual docs who make up the numbers. Those docs come and go. The fact that even USA Today points out, is that most are clustered around an “average.” And that means you get basically the same quality of healthcare service in the US wherever you go with few exceptions.

As for those exceptions, they are few and far between, so they’re not accessible for all of us. And if we all go them, their ability to provide that quality of service will suffer as they realize increased volume and stress on their systems.

And still, I can go to the best hospital in town, but it comes down to the doc. If I have a condition the doc has not seen before, the quality is arguably going to suffer. Or possibly worse, if they’ve hired on some quack, and I get stuck with them in the ER, my quality experience will suffer.

That means that failing reliable data on a specific doc if all healthcare clusters around “average,” then the only quantifiable differentiator is price. So what is reliable data? Malpractice information? Do I look at number of claims or size of awards or awards in aggregate? Or should it be malpractice claims for a certain condition versus number of times treating that condition?

Maybe outcomes data is more important. So do I look at number of deaths? Make sure it’s severity adjusted so you don’t knock the doc for seeing a higher number of really sick patients. And be sure you take into account if the doc has just picked up a new procedure that will improve those abysmal outcomes he/she has been having.

This is why Zagats has gotten into the ratings game - it’ subjective - entirely. The meal you get one night at a restaurant is not the same meal you get the next night. The chef may change. The steak may be fresher. There may be a larger crowd.

It’s the same with healthcare. Have a procedure done. You might have a better blood pressure and better conditioning than the other person. Certain procedures may be valid for you but not for someone else.

It’s subjective. Quality in healthcare is almost entirely subjective. The quantifiable metric is cost. That’s the primary reason we chose to pick up the Hospital Value Index in our application because they factor cost in where others do not. So since everyone is basically “average” without specific data on a doc, ask this simple question the next time you require healthcare, “How much should I pay for this snake oil?”

So with the high cost of energy and that subsequently driving the cost of many things including delivering goods and services, it is small wonder that healthcare is starting to see people cut back.

I’ve seen a good number of articles already on people allowing their insurance coverage to lapse. They are forgoing the premium cost in an effort to save money. That’s a big short-term gamble. It’s a HUGE long-term gamble. Chances are, if someone drops their coverage, they won’t see a need to pick it back up until, well, they really need it. And then it’s too late.

And people are starting to cut back in other ways, too. In the face of efforts by employers to implement wellness programs and disease management programs, people are starting to act counter to that arguably wise practice. A recent WSJ post documents how Americans have begun to forgo those screenings and well care visits. that’s like not putting a new roof on a house until the rain water coming in has rotted out the floors from the leaks.

There are lesser ways to cut healthcare costs. Find a lower cost provider of the service you require (sorry for the shameless self-promo, but it’s what we do). Find a provider closer to you, so you don’t incur the fuel costs (again, sorry for the shameless self-promo, but…). Shop your prescription prices (um, sorry…). Just get engaged with your health and be aware instead of being passive. After all, it is your health, and if you don’t have your health, what do you really have anyway?