When I was operating employee health plans I would frequently have “discussions” with employees when their doctor (almost always out of network) charged far more than the plan allowed as a reasonable and customary fee. Generally I would hear that the doctor was the “best” that’s why he charged more or “he saved my life, I don’t care what it cost” … until a large portion of the fee was out of pocket. I have no doubt that many patients equate high quality health care with high cost. After all, that is generally true when we purchase many goods and services.
However a new study by health researchers concludes that the link between high cost and high quality health care remains unclear with inconsistent findings. The report of study results notes:
Of the 61 studies that met the inclusion criteria [in the overall study], higher cost was associated with better quality of care in 21 (34%), indicating a positive or mixed-positive association between the 2. In 18 studies (30%), the association was negative or mixed negative (lower cost was associated with higher quality), and in 22 studies (36%), the association was nonexistent, mixed, imprecise, or indeterminate.
We tend to transfer our beliefs and every day assumptions about purchases to health care. But health care is far more complex, more imprecise and highly emotional to do that accurately.
More money spent on health care, indeed simply providing more health care is not automatically more efficient or beneficial. We must continue to work toward the worthy goal of a balance between what we spend on health care, what we can afford to spend and the value received. Health care providers and insurance companies cannot find that balance without patient involvement in the process.