Newtown, CT – November 2, 2012
On the wake of Irene, the importance of transparency took center stage and was applied to Sandy – The Governors of Connecticut, New Jersey and New York learned the lessons from last year's debacle and set out to ensure that the utility companies that operate in their States be open and honest about what to expect and when. As such, while utility customers might not be happy about the power outages, they can log on to their utility's website, monitor the level of outages, report their own and get periodic updates with estimates on restoration. Last year, most of us who were affected by serious outages couldn't get a straight answer from our "supplier". We, the customers, were left in the dark, literally and figuratively. And then, to add insult to injury, the utilities went whining to state legislators to request fee increases for all the extra work they had to do. While the aftermaths of Sandy will be felt for a while, it only took one bad previous storm to ensure that full and complete transparency becomes the norm. And yet, in healthcare, the catastrophes, personal and business, continue to pile up every day. Premiums go up, personal healthcare debt goes up, patient safety failures continue and, as of today, 69,519 more people will die in the US from preventable failures in healthcare than should, if our system were on par with the better ones in the world. If that isn't a catastrophe, what is? And guess what…they're clamoring for fee schedule increases to clean up the mess. The utilities got the message after one nasty event. In health care thousands of nasty events still haven't made a difference.
What this means to you – Transparency is, for all intents and purposes, absent from healthcare. Patient safety failures continue to be underreported and shrouded in secrecy. Quality metrics trickle out and it takes heroic efforts like those from the folks at Why Not The Best.org to provide some data that makes sense to the average person. And pricing information is all but absent. Gallingly, some health plans are actually blocking attempts at transparent pricing for plan members instead of actively promoting it. Many, of course, are pushing hard in the right direction and should be rewarded. States have passed legislation that promote greater transparency in healthcare, but only 14 have it about right, and none have it all the way – i.e. in a manner that would provide individuals with the needed rights to know, ahead of time, how much will come out of their pockets when they need a specific set of services. This week, Catalyst For Payment Reform has issued a number of important and useful documents that should help move the dials. And the employers that have committed to supporting CPR should be commended for pushing this through. But now the hard work truly begins, because reports and papers don't change an industry. Swapping out uncooperative TPAs, will. Deploying comparative provider pricing and quality tools to plan members, will. Promoting the right type of legislation, will. Saying no, hell no, to the status quo, will.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.