Monday, September 25, 2006
Free market health care? Not so much.
If we treat health care like any other market, allowing consumers free rein to purchase the services they like best, will it produce high quality results? A recent study suggests not:
Researchers from the Rand Corp. think tank, the University of California at Los Angeles and the federal Department of Veterans Affairs asked 236 elderly patients at two big managed-care plans, one in the Southwest and the other in the Northeast, to rate the medical care they were getting. The average score was high — about 8.9 on a scale from zero to 10.
In the second part of their study, the medical researchers systematically examined 13 months of medical records to gauge the quality of care the same elderly patients had received. The average score wasn't as impressive as those in the patient-satisfaction surveys: 5.5 on a 10-point scale. But here's the interesting part: Those patients who graded the quality of their care as 10 weren't any more likely to be getting high-quality care than those who gave it a grade of 5. The most-satisfied patients didn't get better medical care than the least-satisfied.
Surprise! Patients are poor judges of whether they're getting good care. And if consumer preferences don't map to high quality care, then a free market in health care won't necessarily produce better results or higher efficiency, as it does in most markets.
Back to the drawing board. Perhaps a national health care system would be a better bet to reduce costs, cover more people, provide patients with more flexibility, and produce superior outcomes. After all, why are we satisfied with allowing the French to have a better health care system than ours even though we're half again richer than them?
Researchers from the Rand Corp. think tank, the University of California at Los Angeles and the federal Department of Veterans Affairs asked 236 elderly patients at two big managed-care plans, one in the Southwest and the other in the Northeast, to rate the medical care they were getting. The average score was high — about 8.9 on a scale from zero to 10.
In the second part of their study, the medical researchers systematically examined 13 months of medical records to gauge the quality of care the same elderly patients had received. The average score wasn't as impressive as those in the patient-satisfaction surveys: 5.5 on a 10-point scale. But here's the interesting part: Those patients who graded the quality of their care as 10 weren't any more likely to be getting high-quality care than those who gave it a grade of 5. The most-satisfied patients didn't get better medical care than the least-satisfied.
Surprise! Patients are poor judges of whether they're getting good care. And if consumer preferences don't map to high quality care, then a free market in health care won't necessarily produce better results or higher efficiency, as it does in most markets.
Back to the drawing board. Perhaps a national health care system would be a better bet to reduce costs, cover more people, provide patients with more flexibility, and produce superior outcomes. After all, why are we satisfied with allowing the French to have a better health care system than ours even though we're half again richer than them?
