Four years ago, Dave deBronkart spoke at a medical conference, with his face displayed on a giant screen. Afterward, a doctor told him that a spot on his face looked like basal cell carcinoma.
She was right. That cancer was unlikely to spread, but it needed to be treated, and deBronkart's health insurance policy had a $10,000 deductible. Any treatment, then, would come out of his pocket. How would he find the right treatment at the right price?
The reason deBronkart was attending the conference was that he is an advocate for patient involvement in health care. So he decided that, as an experiment, he would invite proposals on his blog, e-PatientDave. He outlined what he was looking for and asked health care providers to bid for his business.
No one did, of course. "I didn't expect to get a response," he said. "Hospitals don't have a 'submit a bid' department. But you hear over and over that patients are the reason for high health costs. I pursued it as far as I could to explore what happened when a patient tries to be a responsible consumer."
He began calling around to hospitals asking the price of various procedures. "The hospitals said 'we don't know; ask your insurance company.' The insurance company said 'we don't know; ask your hospital,'" said deBronkart. "That was when I smelled a great big rat."
After many, many calls, he chose his surgery: excision, total price $868. Today he is fine.
But his point stands: Health care operates very differently from anything else we buy.
"The actual information I needed in order to be an effective, responsible shopper was by policy blocked from me," he said in an interview. "It's not just a matter of lowering costs. It blocks innovation. Somebody does a good job — better quality, better price — but there's no way for people to discover them."