In the health care world, it has become fashionable to be in favor of "transparency," which roughly means public access to how well providers deliver care and what they charge for it. I agree with this. Health care is one of the few industries in which consumers do not see this information, and it is time to change that.
There are two ways to provide information on how well providers deliver care. One is based on processes, e.g., what percentage of emergency room patients with chest pain are advised to stop smoking (yes, that is one that is commonly collected.) The other is based on results, e.g., what percentage of cardiac surgery patients survive. Both can be important, but is obviously the latter that most consumers will care about. I am in favor of publication of both of these kinds of data, but especially the latter.
The price issue is more problematic. Hospitals and doctors don't get to set their own prices. These are negotiated with insurance companies. Recently, two CEOs of insurance companies in Massachusetts, Charlie Baker of Harvard Pilgrim Health Care and Jim Roosevelt of Tufts Health Plan, were heard to say or were quoted in the newspaper as being in favor of posting the prices that hospitals and doctors charge. Did they really mean that? This would mean that HPHC and Tufts would have to disclose to the world the rates that they have negotiated with BIDMC, Mass General Hospital, New England Medical Center, and the like -- in addition to the rates they pay different groups of physicians. In the past, sharing and publication of these rates was not permitted and was actually a violation of anti-trust laws.
Let me make it clear. We would LOVE to have those prices made public because we believe it would make clear that the largest player in our market, Partners Healthcare System (the owner of MGH, Brigham and Women's Hospital, and several others), gets higher rates because of its market dominance. We would rather have rates based on the quality of patient outcomes -- where the providers that achieve better results would be paid better. Maybe that is what Jim and Charlie are hoping for, too, so they can get out from under the market power of Partners and so consumers could make more rational choices about where to get their care. Maybe they believe that the best way to achieve it is for the state to order them to post their prices. Whatever their motivation, they deserve our support.