Advocates for consumer-driven health care (CDHC) have argued for years that there should be more transparency when it comes to revealing the true cost of medical goods and services. After all, one of the main rationales for these types of health plans is that they encourage patients to ask their providers more questions about the course of care they are being recommended and then to pursue the path that will deliver the best results for the cost.
In practice, there is a problem with this presumption. It turns out that in the real world accurate pricing information is very difficult to ascertain and the price may be different for you than it is for me depending on the ability of the carrier that insures us to obtain discounts.
So, why not just ask your doctor how much the test he or she just ordered will actually cost? Well, the fact is your doc probably just doesn't know.
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An recent article written by Susan Okie for Kaiser Health News in collaboration with the New York Times, points out that doctors in training have traditionally been insulated from information about the cost of the tests and treatments they order for patients — in fact, she says, that for decades, the subject was virtually taboo when professors and trainees discussed treatment decisions during hospital rounds.
As a result of this gap in their training, Okie says that most physicians enter practice with little sense of how to make the most cost-effective choices for patients, or how their own decisions affect the patient's — and the nation's — medical bills.
According to Okie, this gap continues to exist even though, since 1998, the agencies that accredit medical schools have required some teaching about cost awareness and risk-benefit analysis to be incorporated into their curriculum.
Furthermore, the article points out that even if relative costs are known, expensive tests are sometimes ordered just in case the physician may have missed something important for the fear of being sued.
Certainly, CDHC is not a "silver bullet "answer to containing the nation's health care costs. However, if it gets us all asking about the cost of treatments, it is a significant improvement over today's prevailing system where doctors make purchasing decisions on behalf of patients but don't really know what anything costs. Ultimately, we all pay the price for this blissful ignorance in the form of higher health care premiums.
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