It's Time We Did a Little Comparison Shopping.

Hey, psst! You know that colonoscopy your doctor insisted you have last month? Did you know your doctor charges more than any other doctor in the city? Yeah, you want to know how much more? Well, I can't tell you. You can look it up. Any one can. But you can't publish the numbers. You can't set up an app so that the next guy who needs a colonoscopy can do a little comparison shopping. Even though you and I are paying the bill, either through insurance, or medicare, or through reduced salaries every paycheck. Why can't anyone publish the numbers? Because medicare says so. Even though we, as taxpayers, pay the bill. As part of the Obama Administration's efforts to make our healthcare system more transparent, the Centers for Medicare & Medicaid Services (CMS) prepared and released a data set that lists the numbers and costs of all the services provided by physicians and paid for by Medicare in 2012. You can get the data set here. For every different procedure performed by each doctor, the data set lists the number of times the doctor performed the service (delivering a baby, replacing a hip, giving a facet-block injection), the average amount (s)he billed for the service, the average amount allowed for the procedure, and the average amount paid to the doctor. Great stuff, right? Time to do a little comparison shopping, right? It would make a great app! Put in your city, the operation you need, and see which doctor is the most expensive, which is cheapest, maybe select one in the middle? Or that great surgeon your neighbor loves, maybe rule him out 'cause he's twice as expensive as anyone else. Any other business in the market, but not healthcare. The data set has a very restrictive license.

"You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS." "Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt."

That's the good old American Medical Association, arm-in-arm with the Centers for Medicare & Medicaid Services that want to make all that cost data "more transparent". Maybe they just want to keep the good old over-priced system running, where the insurance companies and the hospitals and the doctors divide up the pie, and keep the customer, the patient, in mushroom mode. Of course, all this medical information is too important to allow the patient to see it; they might get confused, might not understand just exactly why they need to be charged so much. Even though that poor patient pays more than twice the average amount as patients in any other industrial country, and get results that put that poor patient out of the top 20 in terms of results. Seems to me it's time we demanded that we be given the data we have paid for, to do what we wish with it. It's time we be allowed to do some comparison shopping. It's time the patients were treated like consumers, to be given a service, and treated, rather than a condition to be billed. Hospitals and physicians in Sweden and India are getting better, and cheaper, results, better outcomes, and costing less, by improving their care. Our system is working hard to preserver the status quo, and outcome we can't live with.