Re: Be afraid, be very afraid Health Info

[David Farber <dave () farber net>]

Begin forwarded message:

From: Karl Auerbach <karl () cavebear com>
Date: April 7, 2009 9:52:32 AM EDT
To: "David P. Reed" <dpreed () reed com>, dave () farber net
Subject: Re: [IP] Re:    Be afraid, be very afraid Health Info

David P. Reed wrote:
> Karl - the idea you propose is a standard that could be used to  
> organize many of the activities being proposed to make health care  
> affordable.  Call it "single estimate, single bill" - analogous to  
> single payer - and it has a nice "bipartisan" political soundbite to  
> it.
> It's far from "shovel ready" though.  To achieve that goal requires  
> nothing less than a vast restructuring of the entire health economy  
> - all of its institutions.  Perhaps we could have the ribbon cutting  
> in one year, and the new structure would be complete in 2025.

Thanks for the additional information about the gordian knot aspect of  
the entrenched system.

I do kinda like your phrase "single estimate, single bill".

Unlike medical records unification the job of giving consumers better  
estimates and better bills does not need to wait for a national  
unification of standards and formats and protocols.  Rather we can  
begin with a simple requirement, much like that in the Fair Credit  
Reporting Act, that demands that health care providers give reasonably  
complete estimates beforehand and bills afterwords, letting the  
providers work out the details for their own systems.

Then we can see how well that works and if not we would have more  
information and could do focused corrective legislation.

For example if after providers have had a chance to create usable  
estimates and bills we find that consumers can't do cross-provider  
comparisons, then we can start to deal with that particular issue,  
which is one that would require national standards for representing  
information.

> That contracting structure has a life of its own.  It cannot be  
> destroyed by a tiny uprising of citizens with shovels attacking Dr.  
> Frankenstein.

I'm not sure that this uprising would necessarily be tiny.

One thing that is in auto repair estimates that I think we can drop  
from medical ones is this: the saving and delivery of removed parts.

                --karl--




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