Newtown, CT – April 5, 2013
The power of report cards is truly amazing, especially when it's on something for which everyone should get darn close to an A – Last month, with our friends from CPR, we published a report card, with little fanfare, on how well states are helping their residents understand the price they're paying for health care services. Two states got an A (NH and MA), and a bunch got an F (including my home state of CT). The report card, perhaps because it came on the heels of the Time article on health care costs, received a lot of attention. A lot more than we ever thought we'd get. And it seems as if the one-two punch is having an effect. Policymakers and ordinary citizens from coast to coast have launched hearings, inquiries and activism to change the laws on the books and lift the shameful veil of secrecy that covers 18% of the US economy. Sure there will likely be some unintended consequences, some leaping before looking, but in the end we will all be better off, and far better to act than to wait for our pockets to get picked again….and again….and again….and again. Here's why. Over a decade ago, on the heels of To Err Is Human and an AHRQ report, Making Health Care Safer: A Critical Analysis of Patient Safety Practices, a similar one-two punch led many hospitals to engage in important process improvements to reduce the shocking rate of fatalities from preventable errors. And yes there were some unintended consequences, and yes there was some leaping before looking, but in the end we are better off for their actions, as can be seen in an important supplement published in the Annals of Internal Medicine.
What this means to you – The Annals supplement is a must-read for anyone interested in improving the affordability and quality of health care (in the US and anywhere else in the world). The various articles show that some experiments didn't yield the promised results, but others did. The authors sum it up in an editorial that contains the top 10 patient safety strategies that should be done now, and another batch that should be broadly encouraged. These strategies will save patient lives, and will also result in better report cards for the hospitals that use them. And it should, because those (and they are many) who have taken patient safety improvement seriously deserve an A – look for example at these shining stars. However, those that haven't deserve an F. For all of us, a good indication of the validity of a report card is by the extent to which the Fs squeal. And whether it's our recent report card on transparency, or Leapfrog's report card on patient safety, the Fs they are a squealing. And that's just fine because we're doing these report cards to inform consumers, to help them manage their financial and physical health, and to avoid them incurring unneeded, unwarranted, and unjustified harm to either. We don't care how many of the agents of the status quo squeal because it's time to stop putting lipstick on the pig, slice off the excess fat, and give some of the bacon back to the people from whom it was unjustly taken.
Francois de Brantes
Health Care Incentives Improvement Institute, Inc.