Consumer-Driven

In my line of work, I hear a lot about health care and consumers. The new rage, especially in the insurance industry, is "consumer-driven" health care, that is, health care in which the consumer takes on more responsibility for decision-making—as well as more financial responsibility, in many cases.

This sounds good, and I don’t think there are too many people who don’t agree that consumers should be as involved as possible in their health care decision-making.

However, some odd twists come out of this new model. I was recently talking to a Medicare official about a new Web-based quality measurement site that gives consumers information on hospitals and their performance in certain specific areas. The Medicare official was talking about how consumers could use this information to decide what hospital to use. Again, sounds good.

But when I looked at the information being provided, most of it was in the area of heart attack treatment. And this thought occurred to me: If I’m having a heart attack, am I going to crawl over to my computer and do some quick Web surfing to compare hospitals? Probably not.

Now, we could say for the sake of argument that someone could plan ahead for a heart attack, although that doesn’t really sound too realistic to me. Or we could say that overall, this kind of thing should be encouraged because eventually a lot more medical conditions will be covered, and (for example) knee replacement surgery will be more practical to comparison-shop for than a heart attack.

But I still wonder if this approach isn’t a little backwards. Instead of saying to people that health care is a supermarket and you have to figure out the best products, shouldn’t we work on making sure that the system is of a uniformly high quality to start with? And in reality, isn’t it true that the quality of health care we receive in this country often has much to do with our socio-economic status to begin with? How will consumer-directed health care solve that problem?

Health care is the most complicated field I know of when it comes to making decisions. More information is good. But finding time in our busy lives to do the amount of research necessary to make informed decisions about every health care problem that our family encounters, well, I don’t know how we get to that point. Do you?