Government's Role in Health Care
By Arnold Kling
The theory: Give consumers more information, let them choose the best provider and the resulting competition will help to squeeze out costly waste and ineffective care. After all, markets work pretty well for other goods and services.
The notion has some appeal, and a dose of market medicine would help some of what ails the nation’s health-care system. But as a cure, the approach rests on the belief that health care is — in most respects — like any other product.
An intriguing new comparison of patient-satisfaction surveys and medical records suggests one big way in which health care differs. The bottom line: Just because patients say they’re very happy with their doctors and the care they’re receiving doesn’t mean they’re getting good care, as defined by medical experts.
He reports on a study in which researchers from Rand Corporation compared the quality of health care received, based on Rand’s measures of quality, with the perceptions of consumers. Consumer perceptions were incorrect.
In my opinion, this study does not prove that informed consumers make bad decisions. Instead, it proves that consumers are not well informed. The final sentence in the article is more accurate.
But confusing high scores on patient-satisfaction surveys with high-quality medical care can be dangerous to your health.
Right now, no one has good information on the cost-effectiveness of medical protocols. Consumers don’t have it, doctors don’t have it, and government bureaucrats do not have it.
In Crisis of Abundance, I argue for a national commission to study the cost-effectiveness of medical protocols. I think that government has a valid role in producing and disseminating this information.
Absent good information on cost-effectiveness, government health care decisions will have no more rational basis than decisions made by consumers. Only when the information has been produced and disseminated can one have a debate about whether consumers are less capable than government when it comes to making health care decisions.