amednews: Physicians ask patients: What is this visit worth? :: May 24, 2010 ... American Medical News I haven't been writing about health care lately, partly because I got burned out writing so much about reform before the law was passed and partly because I am unsure about what will happen next. That and the fact that there are so many other issues that need to be addressed led me to back away from it for awhile. I do post many health care articles on my twitter account, accessible from this blogsite, and I encourage you to read them and think about the many different opinions and points of view. No doubt about it we need to deeply reflect on the magnitude of the law just passed and what it will mean for providers and patients alike.
That being said, I just had to post this particular article here today because it strikes at the core issue of health care reform. Click on the link to find out what happened when some physicians decided to offer "pay-what-you-can" days to uninsured patients. Physicians set aside a day to let uninsured patients pay what they thought their doctor visit was worth. Patients paid anywhere from zero to a hundred dollars for a visit. What is fascinating about this is that the amounts paid reflected the VALUE rather than the actual COST of the visit. As a nurse practitioner I have often asked myself what patients would pay me if they had the choice. Would they be satisfied enough with the care I give them to pay me well, or would they pay me poorly? Would their payment reflect what they thought of my services or would it reflect their opinion of health care in general? Would they base their payment on the amount of time I spent with them or on the quality of advice and care I gave them? If patients had the choice of what fee to pay their providers, would this make them more apt to seek health care on a regular basis? Do patients value their health and medical treatment enough to pay whatever it takes to recover from illness or maintain health? Would patients come to the doctor even if health care was free?
We heard a lot about issues such as cost and access during the health care reform debates but the question of how we value health care has not been fully explored. Yet it is probably the most important one because it drives how patients will use health care in whatever ultimate form it takes. Experiments such as "pay-what-you-can" days are great ways to assess how patients not only value health care in general but also how they feel about their particular provider's care. Certainly more studies in this area would be valuable as we enter the implementation phase of health care reform.
In the meantime I have decided to do an experiment of my own. I do not work in a typical primary health care setting so I can't do a pay what you can day. But I can ask my patients how much they think the treatments I offer are worth to them and what they would pay for them if they had a choice. I will share with you at a later date what I find out.