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Published: Saturday, 11/5/2005

Patient-driven health care gains attention

BY LUKE SHOCKMAN
BLADE STAFF WRITER

What if picking your doctor or hospital were like buying a car?

Maybe you'd sort through a Consumer Reports-like guide to see which doctor or hospital most reliably saves lives. Next to each hospital or doctor would also be a price.

Using this information, you would then make a decision on which doctor or hospital to choose. Evaluating quality and price is how a lot of transactions - from buying cars and DVD players to choosing a new coat or even a cheeseburger - work in America today.

It's not like that with health care. But maybe it should be, said Regina Herzlinger, a Harvard University business professor who spoke yesterday at the Medical University of Ohio. Her presentation was part of a discussion at MUO called: "Health Care Access, Delivery and Cost: Is the Status Quo Sustainable?"

The short answer to that discussion? No.

Dr. Lloyd Jacobs, MUO's president, said the "course we're on is not sustainable."

Health-care costs are soaring every year, and the number of Americans without health insurance - now about 45 million, which is more than the number of Americans on Medicare - continues to grow.

The situation is "almost at meltdown proportions," Dr. Jacobs said.

Politicians and the American public have ignored this problem for so long that the time for tinkering is over, he said, and it will soon take a massive intervention, likely by the government.

"It's too late for incremental steps. My fear is we're going to experience an upheaval. We'll see the bankruptcy of a large corporation like General Motors [partly because of rising health-care costs] and we'll end up looking more like Canada," which has a single payer system, he said.

It doesn't have to be this way, Ms. Herzlinger said. Give patients information and direct control over their health-care dollars, and they'll do a better job at holding down health-care costs, she argued.

This theory, which is being embraced by many companies, is known as "consumer-driven" health care. Though businesses are trying to embrace this concept, it's been a struggle because of the lack of reliable information. "I know more about my car, tomato sauce, and panty hose than I do about the doctor or hospital who is about to perform a mastectomy on me," she said.

Ms. Herzlinger said she favors universal health-care coverage, but not a single payer system because it stifles competition. One major criticism of consumer-driven health care being a solution to rising costs is that it's no help to those who can't afford insurance in the first place. Ms. Herzlinger said she supports things like tax credits or other subsidies that would give all Americans access to insurance plans.

Some are still skeptical. Dr. Jacobs, for example, worries that while consumer-driven health care is a good idea, it's not a radical enough step given the sorry state of U.S. health care. Kenneth Raske, president of the Greater New York Hospital Association and another speaker at MUO's forum, is also skeptical.

He said the "structure of our health-care system is collapsing as we speak," and like it or not, a single payor system is on the way. "It won't happen in 2008 or 2010? Maybe. But it's going to happen."

Contact Luke Shockman at:

lshockman@theblade.com

or 419-724-6084.



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