For someone who worked on price transparency in 2013 - I was personally affected with surprise billing - and spent long hours working on a price discovery / transparency tool called pricepain.com, this (first step of an) anti cartel measure brings tears of joy. While it won’t solve all issues at once, shining some light into the medical billing mess can only be a good thing, allow market forces to enter the picture somewhat. It’s rather sad, that it didn’t come from the industry itself - but I guess that speaks volumes already.
Florida faced a dilemma with their incredibly broken public school system many decades ago and was stuck in a political gridlock as no party agreed on any measure the other would propose to improve the situation. Finally, the only item both parties did agree on, was to grade schools. Just a single simple letter, a search for more light. The result of a little bit more transparency caused a chain reaction of consequences leading to higher quality of service overall. I hope that similarly this move will spark a quality/performance re-orientation and help create more Surgery Centers of Oklahoma. It’s high time.
Something I worry about, and that maybe you can help shed some light on, is what the ramifications of such a move would be.
You mentioned the grading of schools leading to higher quality. Do we know if any metric suffered as a result? One guess I have is that teachers started teaching for the test rather than for the foundation.
Take that same question and apply it back to the issue of hospital cost. If there's more transparency, the obvious conclusion is that there will be increased competition and an overall lowering of costs for patients. Does that come at the cost of quality of care? My gut says no, but my brain says that hospital administrators are incredibly talented at cutting costs. Maybe we have other safeguards such as HCAHPS to prevent the worsening of quality.
And as my own comment on this situation - how does this move fit into the insurance realm? My understanding is that hospitals will display the overinflated prices, but not the individual insurance negotiated prices. So how does this increased 'transparency' help?
> You mentioned the grading of schools leading to higher quality. Do we know if any metric suffered as a result?
We don't know. Something might have suffered but if you're not measuring a metric, you can't really know anything about it. That was the reality of the educational system--very little measurement of anything--and hence the baseline of agreement (not just in Florida but in many states) was simply: let's start measuring.
> One guess I have is that teachers started teaching for the test rather than for the foundation.
This is a good guess, and some teachers and parents definitely agree with you. But the reality is that (again) unless you are carefully measuring a metric, you don't know what is really happening. Collecting a few anecdotes and opinions does not necessarily result in good data.
It's also possible that in the absence of performance metrics, some teachers managed their work to maximize throughput and minimize complaints--by passing students through to the next grade whether or not they were ready. This is also supported by anecdotes, like colleges and employers reporting a decline in student readiness.
It accomplishes little. The tests are a subset of the things the students should have been learning anyway. The idea was that by measuring performance teaching could be improved where needed. The actual result was that the "help" given to classes with bad scores has been to overtrain some tiny neural nets to respond to very specific stimuli without teaching them anything beyond the specifically measured behavior. Even the students that pass often haven't mastered the material. They just can take the test. We opted to replace accountability with process and reaped the usual results.
