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Being Left in the Dark By Our Healthcare System: A Consumer’s Perspective

June 13, 2014

By Elizabeth Bailey

At some point in our lives, we all become consumers of healthcare services. If we are lucky, our interactions with the healthcare system are few and far between - an occasional, minor inconvenience coupled with a limited amount of money out of pocket. For others, particularly those with chronic conditions, these interactions are much more frequent, serious, and costly. It is vital that we as consumers, regardless of the extent of our healthcare needs, are armed with appropriate information to make decisions about our care.

We live in a world where we can access information about almost anything at a moment’s notice. We can evaluate the features, pricing, and quality reviews when making a big purchase, like a new car, or a small purchase, like the best Lego set to buy your nephew for Christmas. Healthcare is arguably one of the biggest and most important purchases one can make; yet the majority of us, as consumers, do not have access to basic price and quality information prior to making decisions about our care.

I recently became a healthcare consumer and quickly discovered that I am not a very well informed consumer. I tried to do my due diligence by researching physician quality distinctions, hospital safety scores, and estimating how much I would need to pay out of my own pocket given my insurance plan. Because of my occupation and background in the healthcare industry, the issue wasn't that I didn’t know where to look for information – the information I was seeking simply didn’t exist for the doctors and hospitals in my area. I made decisions about my care without adequate information and I can’t help but wonder if I had been more informed, would my decisions and ultimately my experience been any different?

I recall my encounter with the healthcare system quite vividly because it was the worst experience with the best possible outcome imaginable, the birth of my son, healthy and perfect. Perhaps a little too healthy, as he weighed in at a whopping 10 lbs, 10 oz! Without getting into the gory details, there were several complications that would be classified as patient safety failures, which increased the length of our stay in the hospital. Thankfully, the complications did not impact my son – but they were difficult at the time and prolonged my recovery. It seemed like we would never get to go home, but we were eventually discharged and life returned to a new state of normal with a newborn. I know my story is not unique and there are many others who have had far worse encounters with the delivery system with far worse outcomes. With more information at my disposal, perhaps I would have chosen a different facility and had a different experience. Maybe, maybe not. But I know with more information, I would not have felt like I was making such important decisions about my care blindly.

Far too many consumers feel this way. The HCI3 state report cards on price and quality transparency reveal that, like me, most consumers do not have access to the information they need to make important healthcare decisions. It’s infuriating and unacceptable and it’s time we make some meaningful changes.

Disclaimer: Elizabeth Bailey is an Implementation Leader for the Health Care Incentives Improvement Institute, the umbrella organization for INQUIREhealthcare.