Plumbers, Consumers, And Health Care Solutions

We can learn a lot from plumbers. And health care would be better for it.

You don't think twice about getting a plumber, do you? You check out the competition, read some reviews, do a little cost comparison, and find the best value for your money. You probably ask friends and co-workers if they have a recommendation.

The plumber then has a project to be done - at a certain price, for a specific level of quality or workmanship. The plumber is now accountable for the outcome. You demand that accountability for the project - on time and on budget - otherwise, you don't pay them fully, or you give them a bad review - or both.

It's pretty simple, isn't it? Some basic consumer principles - the product of a market economy - drive the scenario effectively.

As consumers, we probably pay more attention to our choice of plumber than our health care.

We can solve the problems of health care if we keep these some consumer-driven principles in mind.

1. Consumer choice: You have the choice of any plumber. There aren't a significant number of state or federal regulations that prevent who you select, or when, or how. Freedom of choice is critical - you even tend to take it for granted.

Consumer choice in health care is obscured by multiple levels of arbitrary laws and regulations. Patients should have the right to choose their provider - in all states of the union. The health care system must promote individual freedom and refrain from legislating a patient's care options.

2. Cost transparency: The plumber will tell you what the project will cost and will do so up-front. We demand transparency in this process.

In health care, nobody likes to talk about costs. Costs are hidden and certainly far from transparent to the consumer (and the third party payer). Why shouldn't you demand cost transparency with your health care provider?

3. Competition: I am sure there are plenty of plumbers all wanting to work with you on that project. Competition has never been a bad thing in a market economy. Let the marketplace decide. Competition promotes free enterprise.

Health care providers are wary of competition. Why is that? It forces you to always strive to be the best at what you do. If we did that in health care, the best would thrive and the worst would seek out new careers. Just because you earned that degree doesn't mean you are entitled to be paid for shoddy work.

4. Customer value: The plumber is trying to create value for the consumer. This takes place in many different ways, ranging from what service is provided to how it is provided. The plumber is reimbursed based on the value they provide to the consumer.

Does anyone ever ask the patient if they received good value in their care? Patients want more value, "more bang for the buck" - even in their health care. That doesn't equate to "more procedures". But is anyone asking the patient, and if so, is reimbursement related to value?

5. Clinician accountability: The plumber is accountable for the project. Plain and simple. The plumber is contracted to perform a task and to provide a service.

Guess what? So is a health care provider. Clinicians should be accountable to patients. Just because you performed procedures A, B, and C on the patient does not mean you are entitled to be paid for them - especially if they had no relationship to improving the outcome or value.

6. Limit regulation: There aren't that many regulatory bodies concerned with plumbers. In many ways, they simply provide services to the best of their abilities and level of training and to standards within their trade. The marketplace takes care of the rest.

In health care, licensing and regulatory bodies oftentimes create arbitrary laws that  prevent a clinician from practicing to the full extent of their professional training and/or education.

But will clinicians embrace these consumer-driven principles?

I can see it now. Many clinicians will be cringing at the thought of reviews and transparency. Many will squirm when you mention accountability or, heaven forbid, not being reimbursed based on procedure.

But in the long-term, the cream can and will rise to the top. Not only will patient access to care be improved, but so will reimbursement and outcomes - regardless of the payer.

In many ways, health care shouldn't be any different than finding a good plumber. We think nothing of these principles when our toilet is backed up. Is your health not more deserving of good consumer principles than the plumbing in your home?

Photo credits: Danndalf