These days we hear about consumer education, availability of options, quality of care data etc. that if made available to the consumers, would lead to better choices and lower costs, because the consumers would theoretically be able to shop around for the right medical care according to their needs and their means. While conceptually, the idea is appealing and almost irrefutable, there is a fundamental reason why this has not happened.
I have come across people comparing shopping for a TV to shopping for Medical Care. Conceptually it is a simplistic comparison and should apply equally to Healthcare. But there is a fundamental difference that is overlooked in the comparison – when we buy a TV, we are buying a bundle of size, features, style, brand, quality and reputation and we pay one price for the entire bundle. When we buy medical care, we buy a bundle of outcome, quality of care, peace of mind and wellness, but we pay not for the bundle, but for individual services that go in creating the bundle. Now imagine having to pay for all the components that go in making the TV and all the activities that anyone performed in making the TV. Imagine wading through this detailed component level cost data and process cost and comparing one TV model vs another and trying to come to a conclusion on which TV to buy.
I am sure, not matter how much component level cost information is made available to the buyers of the TV, comparison shopping at that level does not make sense. So is the case with healthcare. Procedure level pricing and costing is not going to simplify the comparison and buying process. Treatment bundles need to be created, costed and priced for consumers to really make a meaningful choice. This is different from an Outcome based pricing, and in many ways is the middle ground between Procedure based pricing and Outcome based pricing that might just be workable.
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