Tuesday, October 29, 2013

Opening the Marketplace: The Next Steps for Healthcare

Buying fruit is far simpler than choosing a doctor.
But as a patient, you still need to be an educated shopper.
Whether or not you believe in the new Health Insurance Exchange, it's hard to argue against the economic principle behind it: an open marketplace encourages competition, better products, and lower prices. The problem is that the the exchanges don't go far enough. The issue is not about how much you pay, but about how much others pay for the same service.

Most insurance plans only partially cover the price of a medical procedure and often, doctors will require patients to pay whatever their insurance doesn't cover. These extra costs can vary widely, and together with copayments and deductibles, leave many patients with medical bills they can't afford. We don't want to be cheap when it comes to our health, and asking for prices upfront somehow seems a little uncomfortable.

So how do we solve this problem? Obviously, there's no panacea. But here are two concepts that I think need to be part of the solution:

Reviews: Patients need to rely on more than just referrals to decide on their doctors. They need honest recommendations and facts. The website ZocDoc.com already provides physician reviews and allows patients to book appointments online; but to be effective, reviews need to be more widespread. There are privacy concerns for sure. Many patients don't want to talk about their medical struggles online. Still, to make healthcare more affordable, patients must be able to evaluate the quality of the doctors available.

Price Lists: Patients need to know the prices of procedures. Obviously, cost is not the only factor in deciding which doctor to see. But it is a factor and needs to be addressed. There are ways for people who can look up insurance and have a lot of time to research prices, but that is not practical for most patients. There are also websites that provide average rates for procedures by area, including Healthcare Blue Book and FAIR Health. But they don't tell you which doctor in your area has the best price. Customers need to be able to comparison shop and evaluate the quality of the available products to make educated decisions.

These are just a couple of ideas, and I would love to hear what you think. Feel free to comment below or on social media.

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