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Commentary: Better information equals better health

This article first appeared in the St. Louis Beacon, March 23, 2009 - Health care in America costs too much. It's threatening the financial survival of our families, our employers and our economy.

Even more troubling, we're not getting our money's worth. Health care suffers from insufficient, inconsistent quality. Far too often, patients are harmed by the system that was supposed to help them.

A bill likely to be voted on by the Missouri House of Representatives this week could improve our state's health-care system by giving patients better information on the quality and affordability of health-care treatments and providers. HB 497, sponsored by Rep. Doug Ervin of Kearney, would also require hospitals to tell patients when certain serious medical errors occur and waive payment for costs associated with those errors.

The United States spends more per person on health care than any other country in the world, about $7,600 for each man, woman and child. Despite this investment, the U.S. ranked last in health system performance among industrialized nations in a recent Commonwealth Fund report.

Of all states in this nation struggling to provide high-quality, affordable medical care, Commonwealth found Missouri's health-care system to be among the worst. Our state scored in the bottom half of the nation in nearly every category. Missouri received its worst scores in healthy lives, health system quality and avoidable hospital use and costs. We all must take responsibility for condition of our health-care system and for improving it. Missourians deserve better.

We know there are stark differences in health care, even within a community. Patients receive recommended care only 55 percent of the time, according to a 2003 landmark study published in the New England Journal of Medicine.

Sadly, there are dangers in health care as well. Serious medical errors in hospitals kill an estimated 100,000 people a year, the Institute of Medicine found. That's more deaths every year due to errors in hospitals than from AIDS, breast cancer and car accidents combined.

Unfortunately, patients in St. Louis do not have good information about where these differences and dangers exist. In most other metropolitan areas, patients have access to consumer-friendly websites and publications with information on the quality and affordability of health care.

Here are a couple of examples. People in the Philadelphia area can easily find that patients who were admitted to St. Mary's Medical Center for congestive heart failure had significantly higher than expected mortality rates. They can also see that patients with the same diagnosis admitted to three other hospitals in the same region had significantly lower than expected mortality rates.

Meanwhile, in Seattle, people with diabetes can research physicians to know which doctors consistently perform recommended screenings to prevent complications. They can also find out which are best at helping patients keep their blood sugar, cholesterol and other risk factors in check. Patients deserve to know this information. Their lives could literally depend on it.

HB 497 would give Missouri patients and their physicians the information they need to compare treatments, doctors and hospitals based on results. With this information, patients can make the best decision for their health, their families and their budgets.

Perhaps most promising, public reporting can inspire systemic improvements in medical care. A 2003 study published in Health Affairs found public reporting of information about quality of care led to more rapid improvements in quality. National health-care public reporting efforts such as Hospital Compare and Nursing Home Compare show similar results.

Supporters of HB 497 include some of the state's largest employers, union members and consumer groups. We urge you to join with us and ask your state representative to support this critical piece of proposed legislation.

Healing the health-care system needs more than doctors and nurses. It requires all of us to advocate for change, live for health and shop for value.

Louise Probst is executive director of the St. Louis Area Business Health Coalition.