Consumers Can Play a Role in Transforming the Health Care Delivery System

Posted by: David Morales, Commissioner, Division of Health Care Finance and Policy

I spend a lot of time talking about the Massachusetts health care delivery system, mostly to researchers, legislators, employers, advocates, and the like, but rarely do I have the opportunity to speak directly with consumers. 

Yesterday, I had the pleasure to do so at a Health Care for All (HCFA) Consumer Health Quality meeting. This Council is comprised of volunteers that have been personally impacted by medical errors or quality deficiencies. I applaud their commitment to injecting the consumer voice and perspective into key health care policy discussions and legislative debates. 

I was asked to present to the Council on the Division's work and how consumers can play a role in transforming the health care delivery system. It was a great opportunity to share some of the key findings of our Health Care Cost Trends 2010 Final Report and highlight our policy recommendations as they relate to consumers. 

We engaged in a very important discussion about issues like cost, quality, wellness, and transparency. The latter topic was a strong area of interest for the attendees, as it is also for the Division. I mentioned the agency's current work on developing the all-payer claims database (APCD). While the APCD is not the solution to mitigating health care costs, we strongly believe that by offering full access to the true price of our own medical utilization - doctor visits, hospitalizations, diagnostic tests and the like - we can lift the veil that currently masks the full price tag we all pay toward health care. Accurate, detailed, transparent data should be the driver of decision-making for policymakers, employers, and consumers. 

Indeed, as one of the Council members noted, consumers must have access to user-friendly data that helps identify the highest quality care at the best possible value, rather than relying on anecdotal advice from family and friends. It is also essential that we, as consumers, better understand that our personal health habits and our health service utlization patterns are directly tied to the increasing cost of medical care as well as the cost of health insurance premiums.

We need more meetings and conversations like yesterday's to take place all across Massachusetts, where we are able to directly engage consumers and employers about rising health care costs.  We must also continue developing the appropriate tools and resources for consumers so that they can become more prudent purchasers of health care. 

 

Comments

[Richard at Patent Attorneys in CT]

A very nice topic to discuss. I definitely agree to what the topic is all about. We ,as the consumer, should be given the right to know the prices of our medicine. We wouldn't spend that much if our budget isn't that enough. But our health is very crucial and must be taken care of importantly.

[torrent download]

I know we all go to the grocery store and check prices before we buy something. I feel our health should be treated the same. This gray area where it promotes underpayment and overcharging is wrong. Plus all services should be listed with fees.

[Cindy Lees]

My comment is this. There seems to be no way of knowing what something will cost when an insurance company is involved. I once called a pharmacist to see what a 30 day supply of my medicine costs. Answer it depends on your insurance. I just wanted original cost. He wouldn't tell me. I have to have blood work done. No one will tell me the starting or ending cost.
THIS IS WRONG>
It should be well known what the cost of any procedure etc is before we commit to it. Rather than hold our breath when we find out we have deductible and co-pays etc.
My son recently went to ER for a concussion and broken nose. Yes he had both. We got a $1700.00 bill of which I had to pay a co-pay of $150.00 (I knew this). But now I find out any Labs or Xrays done in the ER on this visit are not covered (have to meet a deductible) interestingly the hospital charged over $1200.00 for these tests but I only have to pay $85.00.
So the question is if insurance companies paid more, and hospitals charged a fair amount couldn't we afford to give everyone insurance?

I know we all go to the grocery store and check prices before we buy something. I feel our health should be treated the same. This gray area where it promotes underpayment and overcharging is wrong. Plus all services should be listed with fees.

Thanks for your time.