Blog Post: Would You Like to Super-size that MRI? by Jean Hanvik

I recently found myself at a Meetup group that featured a panel of Minnesota’s highest ranking health care influencers from state and city government, alongside a number of health care IT entrepreneurs. With American Public Media’s economics editor, Chris Farrell, as the moderator, the idea was to engage in a discussion about how local government and early stage Minnesota health care start-ups can work together to improve health and access to insurance.

As someone who thrives on taking complex information and simplifying it in ways that enable individuals to contribute to improving health and lowering costs, I found most of the formal panel discussion to be a disheartening confab about “compiling and liberating an excess of data to drive system-wide change.”

It wasn’t until one of the entrepreneurs asked a simple question that the discussion moved away from the merits of actuarial and economic modeling and on to making a real difference in the lives of Minnesotans: “If you had $100,000 to invest in a health care start-up, what could be done to contribute to lowering costs and improving health?”

This led to a deceptively simple answer: “Someone has to stick their neck out on payment reform and transparency to get consumers involved so we can deliver care better, faster, safer and cheaper.”

Those who purchase health care are spending more and more, and the status quo needs to change. So, what’s an employer to do? This recent Wall Street Journal article quotes Princeton economist Uwe Reinhardt who likens using the U.S. health care system to shopping in a department store blindfolded and months later being handed a statement that says, “Pay this amount.” With a captive audience and a vested interest in keeping employees healthy, happy and engaged, employers hold the key to driving real reform from the bottom up.

Imagine Scenario One: A gallon of gas is $1.75 instead of $4.07. A pound of filet mignon is $2.99 instead of $14.99. A week-long trip for four to a fine Caribbean resort is $2,000 instead of $15,500. A Ferrari 458 is $25,000 instead of $310,000.

Now Imagine Scenario Two:  A strep throat diagnosis is $65 instead of $420. A monthly prescription for an antidepressant is $29.99 instead of $280. A CT scan is $495 instead of $1,250. A surgical repair of torn knee cartilage is $3,525 instead of $10,800.

What’s the difference between these two scenarios? The first one will happen only in your dreams. The second reveals choices patients unknowingly face every day when they purchase health care services.

It’s time we begin to seal the black hole that has been drawing precious health care dollars into its vortex for so long by taking back control…and teaching those who look to us for inspiration and education to do the same.

While it was clear that all Meetup participants share a deep commitment to protecting, maintaining and improving health for Minnesotans, the seemingly endless complexities associated with health care reform and a system that has been broken for decades has left the consumer out of the equation. Without transparency, forcing high-deductible health plans on unwitting people and expecting them to rise to the occasion will fail. They have no data and no incentive to make economically rational decisions…even when improved health and longer life are the reward.

Health reform has been and will continue to be a major public health activity in Minnesota. The Minnesota Department of Health is engaged in many aspects of this reform in addition to other on-going interactions with the health care system. But what about the people?

Supporters of Minnesota building its own exchange argued that Minnesota could build a system that benefitted from the state’s long history of health care policy innovation and cost containment. They also maintained that Minnesota would wind up with an exchange tailored to the needs of state residents rather than a “one-size-fits-all” federal exchange.

Yet even if every, single call to MNsure were answered within 10 seconds, and navigators provided accurate answers 100 percent of the time, and we exceeded our enrollment goals, basic health information continues to baffle and overwhelm even those with advanced literacy skills. According to the National Institutes of Health, about nine out of 10 American adults have some problems with health literacy.

The Minnesota Health Action Group is continuously adding tools and resources to its website that simplify employee communications, and show promise in improving health literacy and consumer engagement. Here are just a few examples that are available in the public domain:

The Minnesota Health Action Group is the only Minnesota organization whose sole purpose is to represent the collective voice of those who pay the bill for health care — employers, public purchasers, and individuals. Involvement in The Action Group seems like a smart place to begin driving innovation, collaboration and engagement in ways that improve health care and ensure the economic vitality of all Minnesota communities.

Jean Hanvik specializes in helping organizations improve health and benefit literacy among employees by simplifying the complex, addressing unique cultural needs, and removing barriers to understanding. http://www.linkedin.com/in/jeanhanvik/

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