Link: OpinionJournal – The Western Front.

More broadly, Mr. Bredesen laid out a philosophy for reform. His analogy was that today health care is like going grocery shopping without any price tags on the food; when you get to the checkout counter, the government pays the tab. That’s a system that will predictably end up costing much more than it has to, because there is every incentive to toss the highest-priced items in the cart, even if much of it will end up going to waste. To fix the system there needs to be “economic tension,” he said. Everyone must pay something for the services they receive. Whether it’s a “copay,” an enrollment fee or even as little as $5, paying part of the cost will give the patient a reason to start making rational decisions about what care is really necessary.

This talk is sacrilege in some quarters, and it’s markedly different from remarks we often hear about doctors making final decisions about health care. In Mr. Bredesen’s view, patients themselves are to be the final arbiters of their care, making informed decisions in consultation with their doctors. It’s managed care, but without the government mismanagement.

This opinion which was in the WSJ and also referenced on the medpundit blog provides further momentum for the growing popularity (and debate) about consumer driven healthcare in which the patient in consultation with their medical provider makes an informed decision regarding intervention, cost, values, etc. This fits right in with the integration aspect of EBP along with best external evidence and clinical expertise. Thoughts?

Larry