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The Vital Health Care Shift Nobody Is Talking About

While politicians and wonks inside the Beltway bubble squabble over the GOP’s latest health care proposal, real change is coming, with or without DC’s help. This WSJ piece gives an excellent overview of the problems with the status quo (huge price fluctuation, lack on consumer information when shopping for care) and the momentum building behind the price transparency movement:

But states are increasingly requiring payers and providers to reveal that information. A few states specifically outlaw gag clauses in health-care contracts. Sixteen states have “all-payer claims databases” designed to collect insurance claims data and use it to monitor trends and identify high- and low-price providers. And some 38 states now require hospitals to report at least some pricing information, although only two—Massachusetts and New Hampshire—rated an “A” in Catalyst for Payment Reform’s annual report card for making the information accessible and usable by patients.

Meanwhile, entrepreneurs are sleuthing out negotiated rates from claims data and making them available to consumers and employers in various forms. Healthcare Bluebook aims to do for health care what the Kelley Blue Book does for used cars: It analyzes negotiated rates paid for thousands of medical services in every ZIP Code—supplied by employers and other clients—and posts what it considers a “fair” price for each so consumers can evaluate what they’re being charged.

Read the whole thing. Efforts like these will provide the real substance of health care reform for years to come. Politicians aren’t talking about these kinds of things because they’re not as splashy as federal policy. That means that media, in turn, isn’t as zeroed in on it as they could be (our thanks to the Journal for bucking this trend).

If we’re ever going to succeed in bending the health care cost curve, gradual reforms that make the system more competitive will be more important in the long-run than high-profile white noise legislation like Obamacare.

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  • Fat_Man

    Looking for medical care developments nobody is talking about? Here is one:

    “This Woman Invented a Way to Run 30 Lab Tests on Only One Drop of Blood” By Caitlin Roper 02.18.14

    [At age 19, Elizabeth] Holmes, now 30, dropped out of Stanford and founded a company called Theranos with her tuition money. … Instead of vials of blood—one for every test needed—Theranos requires only a pinprick and a drop of blood. With that they can perform hundreds of tests, from standard cholesterol checks to sophisticated genetic analyses. The results are faster, more accurate, and far cheaper than conventional methods. … The company plans to charge less than 50 percent of the standard Medicare and Medicaid reimbursement rates. And unlike the rest of the testing industry, Theranos lists its prices on its website … If all tests in the US were performed at those kinds of prices, the company says, it could save Medicare $98 billion and Medicaid $104 billion over the next decade.”

    Eric J. Topol, M.D., the author of “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care” is editor-in-chief of He is also Director of Scripps Translational Science Institute, professor of genomics at The Scripps Research Institute and Chief Academic Officer of Scripps Health. Before that he was chairman of cardiovascular medicine at the Cleveland Clinic and founder of the Cleveland Clinic Lerner College of Medicine. He wrote “Topol Reviews 2013: A Year of Revolutionizing Medicine” by Eric J. Topol, MD,

    “We send our patients to the clinic or hospital lab, or a central facility, to get their blood drawn. Typically, multiple tubes of blood are obtained; the costs are not transparent; and perhaps even worse, the results are not easily or routinely accessible for most patients. Last month, I highlighted a new entity on the scene — Theranos — and interviewed Elizabeth Holmes, the young CEO. Theranos will be in all Walgreens stores before long, leveraging microfluidic technology to do hundreds of assays with a droplet of blood, with a fully transparent cost list, and ultimately with results directly going to both the patient and doctor. After 60 years of unchanged laboratory medicine practice, this new, innovative model will help drive disruption — just the kind of shake-up that we have needed. ”

    Here is a link to the interview:

  • Anthony

    “Economists marvel at our health care sector and its ability to deliver less for more…the United States spends absolutely more per-capita, and more as a percentage of GDP, by a considerable amount. We have been spending more than one-sixth of GDP on health care…Per capita spending in the United States has been two and a half times higher than the average of the advanced industrial countries…While there are many reasons for this disparity in the efficiency of the health care system, rent seeking, in particular on the part of health insurance companies and drug companies, play a significant role.”

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