This piece is worth listening to for a number of reasons. One of my pet peeves since our children’s birth is that consumerism doesn’t apply well to births in the United States. I’m all for women who elect to have a C-section. Personally, for our family that wasn’t the right choice, as my wife did extensive research that suggested that natural births produce better outcomes for the babies.
You can dispute that finding, but what you can’t dispute is that ELECTING to have a C-Section drives up the cost of care in a way that should justify increased costs to the family of the woman making that decision. Planned C-sections are easier to schedule for the doctor and provide an increased revenue stream – as per the report. Thus patients should bear the differential price, thus driving down costs for the rest of us.
This doesn’t apply to C-sections for medically necessary reasons. However, again we could look to the Finland and other developed nations with much lower C-Section rates AND higher infant and maternal survival rates. Nobody should be financially penalized for interventions that are medically necessary.
So why are reimbursements twice as high for OB-GYNs associated with large group practices? Oligopoly Power of course. And herein lies the pathway to truly reducing the (out sized) costs in our healthcare system – remove the perverse incentives for doctors to join these groups, and you’ve taken one step closer to reducing overall costs.
The increase of high deductible health plans SHOULD contribute to reducing costs – but only if healthcare consumers are smart enough to ask questions about cost and become educated enough to make informed decisions.
The most interesting part of this piece for me was the suggestion, toward the end, that consolidated group practices don’t improve the quality of care:
But Kristof Stremikis, associate director for policy at the Pacific Business Group on Health, which represents employers, said that studies suggest that is not the case. “All of the evidence that we see shows that the quality in these larger systems is the same or worse,” he said.
Jenny Gold aught to be careful not to bite the hand that feeds her. But a strong tip of the hat to the impartiality and independence of Kaiser Health News as I’d imagine that the Kaiser organization would argue that they make every effort to improve the quality of the care that they provide.