The grim events that occurred in Boston on Monday comprised the only thing that could distract many people from the fact that it was April 15, tax day.
It's a day of reckoning for most Americans, where they're compelled to pay up and settle accounts. Were it not for the bombings, the airwaves would have been inundated with footage of post offices open late, loops of the Beatles' song "Taxman," and endless debate among the talking heads whether we're actually getting our money's worth.
For the most part, I think we are. But there is always room for improvement. When it comes to healthcare, there are several ways in which I believe our tax money could be used to makes things work better. Here are my thoughts:
1. HIPPAA education
Seventeen years after passage of this landmark law, I am still amazed at the volume of anecdotes and articles about the loved ones of patients who are threatened with banishment or arrest under the color of HIPAA if they ask for too much information. The printing and distribution of booklets at hospitals about the most salient points of HIPAA would no doubt avoid a lot of angst--and probably boost patient satisfaction scores significantly.
2. Officers' statements on 990 tax forms
Ever read a hospital's mission statement on a form 990? Let me paraphase: Our goal is to be the operational version of Mother Teresa. Yet a few pages later, the seven-figure pay packages of its top executives are reported without comment. I recently asked the CEO of a safety net hospital who earns $1.7 million a year whether someone could do her job for $500,000. A pause, and the reply: "Maybe." Nothing could liven up the reading of a new tax form but compelling personal mission statements from the CEOs and COOs--and how they believe they earn the pay they receive.
3. 340B fund transparency
It's disturbing to have discovered that Duke University Medical Center--and likely many more hospitals--used the 340B program discounts they received on drugs to resell them to insured patients for much greater amounts. Instead of going through the rigamarole of changing federal law to quash such abuses, simply use federal funds to print disclosures and distribute them to anyone entering a hospital. I imagine things would change quickly.
4. Pricing transparency
The same approach could be used regarding a hospital's chargemaster. How hard could it be to put together a government-sponsored smartphone or iPad app any patient or their family member could use to download what their hospital charges for a specific procedure? The first step toward greater price transparency.
5. Pharmaceutical lobbying
Every bottle of prescription pills has a list of active ingredients and warnings. It also would be instructive to include a label listing the amounts the pharmaceutical manufacturer spent on political lobbying in the past year--and how that lobbying affected the price of the product.
It's very likely none of these ideas will ever be implemented. But if they did exist, I'd at least take comfort that some of my tax dollars are being spent a little more wisely. - Ron (@FierceHealth)