Your story "Pennsylvania Hospitals Show Better Care is Cheaper Care" is a superb overview of one of the most critical, yet overlooked problems in the U.S. health care reform system: that the cost of health services has little or nothing to do with the quality of those services. In large part this is because consumers and employer purchasers have no information about cost or quality. Imagine if other industries functioned that way: try shopping in a department store where some items cost ten times what other similar items cost, but there are no pricetags and no way to rate product quality or safety. Ridiculous as that sounds, healthcare plays by exactly those rules, and hundreds of thousands of ruined American lives attest to the results. Americans do not get the quality of care we are paying for.
The consequences of this cost/quality disconnect have been dire for American business, which pays higher and higher health insurance premiums with no recognizable impact on the overall health status of employees. Most businesses paid more in health insurance costs than they earned in profits last year. It is fun to blame health insurance companies for this, but business leaders have discovered through harsh experience that health plans are not the whole problem and not the whole
solution: providers must be held directly accountable for their performance by those who are paying their bills. Purchasers and consumers must demand transparency of cost and quality information and then act on that information to favor the doctors and hospitals that offer the best quality and the best price.
Improving performance on cost and quality is feasible. The Leapfrog Group Hospital Survey, founded by a group of Fortune 500 leaders, finds that a handful of hospitals are able to achieve the highest quality standards at the greatest levels of efficiency. But the vast majority of hospitals in our national survey are not high quality and not efficient.
The high-performance Leapfrog hospitals demonstrate through their example that purchasers have a right to expect better from the American healthcare system.
Direct provider accountability for costs and quality is not an academic exercise for the wonks: it's a bottom line concern for American business. If health care reform in Washington fails to institute a forceful mechanism for demanding provider accountability, the resulting escalation of costs will be shifted to private sector purchasers. That is not sustainable, nor is it fair to the employers investing so much in the health and well being of their employees.
