Comments on: change:healthcare aims to make medical costs transparent — but falls short in execution

By: David P. Hamilton

David P. Hamilton — Fri, 07 Mar 2008 07:50:57 +0000

Raj, I couldn't agree with you more. I hope I've made it clear -- if not necessarily in this post, then in others (here and here, for instance), that I'm skeptical about the ideological claims made for consumer-directed healthcare. The problems of the healthcare system are vast enough that I can't help thinking that the most significant changes over the next few years are far more likely to come from Washington than Silicon Valley and other similar centers of technological innovation. The challenge, I think, is going to involve reconciling systemic reforms aimed at broadening coverage and making it more affordable with the entrepreneurial drive exemplified by Health 2.0. That is, of course, a subject for another post (if not a book or other academic treatise).

By: Raj Nihalani, MD, (US)

Raj Nihalani, MD, (US) — Fri, 07 Mar 2008 07:10:50 +0000

Transparency and better public information on cost and quality are essential for three reasons: 1) to help providers improve by benchmarking their performance against others; 2) to encourage private insurers and public programs to reward quality and efficiency; and 3) to help patients make informed choices about their care. Transparency is also important to level the playing field. The widespread practice of charging patients different prices for the same care is inherently inequitable, especially when the uninsured are charged more than other patients.

But it is unreasonable to expect that information on prices, total bills (total costs to patients and insurers), and quality will cause the health care markets to perform like markets for other goods and services. Health care is not a homogeneous commodity. Patients will never have as much information about the care they need as the physicians who care for them. Health care decisions are often made under emergency conditions and emotional stress. Both the insurance industry and the health care delivery sector are highly concentrated, leaving patients with few genuine choices. In short, all the conditions required for perfectly competitive markets do not exist in health care, making the health care market quite different than markets for other goods and services.

Raj Nihalani, MD, RAC(US)
Irvine, Ca 92602

By: Six Health 2.0 firms reinvent doctor-patient ties » VentureBeat

Six Health 2.0 firms reinvent doctor-patient ties » VentureBeat — Thu, 06 Mar 2008 23:14:21 +0000

[...] one hand, this is a welcome innovation. Medical pricing has long been a black box, as I noted here, and with more people being pushed into “consumer-directed” plans that saddle them with [...]

By: change:healthcare wants to empower “medical consumers” — but has more work to do » VentureBeat

Tue, 04 Mar 2008 00:18:55 +0000

[...] this afternoon. And it’s a nifty idea, if unfortunately still flawed in execution. See our review at VentureBeat Life Sciences. Tagged co:changehealthcare, health 2.0, healthcare IT, medical costs [...]