Perspectives On Cost And Quality

The New York Times: Will People Comparison-Shop For Health Care?
If patients know how much their medical care costs, they’ll shop around for the cheapest option — and over time, health care costs will go down. At least, that’s the idea behind the drive to improve price transparency, a strategy embraced by Donald Trump, among others. But a recent study suggests it’s not so easy to get people to shop. Sunita Desai, a fellow in health care policy at Harvard Medical School, and her co-authors looked at two companies that introduced an online tool that lets employees compare prices for things like lab tests and outpatient surgeries. After a year, only 10 percent of employees had used the tool. And those who had access to it actually had higher out-of-pocket spending on average than comparable employees at other companies who didn’t have the tool. (Anna North, 5/6)

The New York Times: Get Ready For Higher Obamacare Rates Next Year
It already looks clear that many Obamacare insurance plans are going to raise their prices significantly. Over the last few years, average premium increases in the Obamacare markets have been lower than the increases for people who bought their own insurance in premiums before the Affordable Care Act. But several trends are coming together that suggest that pattern will break when plan premiums are announced in early November. Many plans may increase prices by 10 percent, or more. Over the last two years, I’ve written articles warning against scary headlines that exaggerate premium increases. Next year, those scary headlines are more likely to be accurate. (Margot Sanger-Katz, 5/6)

Los Angeles Times: There's No Place For Rampant Capitalism In Treating The Sick
A good friend of mine recently found herself between jobs, with a gap in her health insurance and a recurrence of her kidney stones. What she needed were fluids and pain relief, fast. I'm a gastroenterologist, and hoping to minimize the financial impact, I went with her to our local ER and had a conversation with the attending physician. Maybe we could pass on the CT scan and extraneous lab work? The attending was in her room for less than two minutes and never examined her. But the CT scan and blood work were ordered. My friend received intravenous fluids (about $1 worth), pain meds (about $5 worth of dilaudid), and a $10,000 bill from the hospital. To add insult to injury, the bill from the ER attending was for service at the highest billable level. (Michael Jones, 5/8)

Modern Healthcare: The Great Cost Shift
In most presidential election years, the politics of healthcare at least has a nodding acquaintance with reality. This year, the two aren't even on speaking terms. Let's start by correcting some untruths polluting the national conversation. Then I will show what I think is the main reason why millions of Americans are angry about rising healthcare costs: there is a major shift underway in who pays for health insurance. (Merrill Goozner, 5/7)

The Philadelphia Inquirer: Maybe We Are To Blame In Part For Rising Cancer Drug Prices
The prices of oral cancer drugs are rising. This will come as no surprise to anyone who has cancer or who knows someone who has it, but this excellent study documents that fact beyond a shadow of a doubt. Even after introducing a new cancer product at some price, the seller, protected by patents, increased the price by 5% a year on average. This is higher than price growth from economy wide inflation in the same period, while other medical prices also grew excessively, but not by as much, and total drug spending hardly grew at all. (Mark Pauly, 5/6)

The Wall Street Journal: When Doctors Stop ‘Seeing’ Patients
Physicians aptly speak of “seeing” patients. After all, medical training is a series of vision lessons. Students look closely at a nameless cadaver and disassemble it until it resembles the pictures in an anatomy text. They watch lectures in which interrelated organ systems are displayed as simple machines. (Abraham M. Nussbaum, 5/8)

WBUR: In Simulation Era, Your Doc’s First Try At A Procedure Should Not Be On You
Most doctors never forget the paralyzing terror of their first invasive procedure. Dr. Charles Pozner, of Boston’s Brigham and Women’s Hospital, recalls the first time he placed a central line, which involves sticking an eight-inch-long needle into a patient’s jugular vein to place an intravenous line. He had never even seen it done before, but a chief resident offered him the opportunity after a long day working together. (David Scales, 5/6)