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Experts debate effectiveness of consumerism
April 20, 2006
President Bush and administration officials promoted health care consumerism and expanded HSAs, but other politicians criticized that approach at the World Health Care Congress in Washington, D.C. yesterday.
"America's health system should be run by doctors, patients and consumers," Bush said in a taped statement. "HSA owners make their own decisions about health care spending, and that gives them an incentive to get a better value for their dollar."
U.S. Rep. Pete Stark (D-Calif.) disagreed: "I don't have much faith in HSAs doing anything more than shifting costs to the poor and shifting costs to the sickest among us."
In emergencies, "you don't have time to ask the ambulance driver where you are going, much less how much it will cost when you get there," he noted. "When you're talking about choice, you're not talking about the full population." He cited food poisoning, fractures, allergic reactions, strokes and heart attacks as events where choice is impossible.
Allan Hubbard, a Bush aide on economic policy, admitted consumerism doesn't work in those situations, but downplayed that scenario. "You can only shop in a non-emergency. Emergencies represent a relatively small percentage of the cost of health care," he asserted.
Part of the debate focused on transparency of price and quality information. Hubbard warned that Congress will force doctors and hospitals to reveal this information if they don't do so voluntarily.
Bush said, "Americans need to be informed consumers, yet far too much information about price and quality is hidden from patients." However, two doctors in the audience argued that such information in the public's hands causes misunderstandings. Quality is complicated to define and difficult to understand, given the wide disparities in patient demographics and severity of disease, they noted.
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