A Novel Approach

As the clock starts in our efforts to reform out Utah health care system I was encouraged by this Op-Ed in the Salt Lake Tribune.

Making health insurance affordable – forcing carriers to offer so-called “affordable plans” – will not result in affordable health care. . . . our priority must be to restore the health-care provider/patient relationship by providing the patient with cost and performance information and making him responsible for his own care. The government does not tell its citizens what house, car or flat screen to buy, but there is an assumption that when it comes to choosing a health-care service, we are incapable of intelligent decision-making and need intermediaries.

Only when the patient is armed with relevant information regarding cost and a providers performance will that patient be able to make informed decisions. Armed with such information, a patient will shop quality and price, which will drive down costs. (emphasis added)

What I really love about this is that it comes from a completely unexpected source – this article was written by the executive director of the Utah Association of Health Underwriters. Along with her valuable diagnosis, Ms. Smith also offers this idea as a possible approach to explore:

For example, an insurance company might give the patient a benefit credit equivalent to the average price of a knee replacement surgery and the patient would shop around with the information given. Based on this data, he might choose a surgeon with a long record of solid outcomes and a lower price than the benefit credit his insurance has given him.

The insurance company could allow him to keep the change in his Health Savings Account for future health-care needs. This practice is already happening on a small scale in several areas where a hospital lists a global price for a heart bypass and gives a 90-day warranty. No extra charges for pain medication, Band Aids or physical therapy – all are included.

This does not require a mandate for our citizens, and might serve as an incentive to bring some people into the insurance pool. It also allows for comprehensive health insurance plans that keep the patient as the one making decisions about how the insurance money gets spent.

As if that was not enough, Cameron drew my attention to an Editorial in the Deseret News written by a doctor talking about how he improved his practice by dropping insurance plans. Though the article is not explicit on the point, it sounds like he eventually dropped all insurance plans and now only deals directly with patients.

{Many physicians} feel that it’s their mission to serve as many patients as possible rather than to provide the best care possible. Most significant, today’s doctors are preoccupied with the bureaucracy of insurance companies. . .

To be sure, physicians are not entirely to blame. With insurance companies dictating how much doctors can charge for services as diverse as a routine checkup or an appendectomy, a doctor has only one route to more income: increase volume.

Does anyone else want to help ensure that these perspectives do not go unnoticed by our illustrious task force?