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How All of Us Can Nurse Health Care Back to Life

'Comparative effectiveness' is a key for fixing our beleaguered health care system.

If there are two words on everybody's minds these days, they're "comparative effectiveness."

Ok, so probably not. In fact, you've probably never heard the phrase before or about the Blue Cross Blue Shield initiative.

And therein lies one of the problems with our health care system. There is a lot of talk about a consumer-driven market, but whoever came up with that term forgot to tell the consumer. Comparative effectiveness examines different treatments and therapies for the same condition to identify the best options for care.

Yes, we all complain about rising premiums and inefficient or poor care. We may even know of the tens of millions of uninsured Americans, the high cost of emergency room visits and the political jockeying of how to "fix the system."

But let's face it -- as much as we like to think we are altruistic -- what we really care about is ourselves. And that is OK, because that is the key to fixing the system. In a consumer-driven market, we as consumers of health care should demand better quality, better information and more-efficient care.

In the wake of several corporate scandals over the past few years, Americans have increasingly called for higher standards in public financial reporting and accountability.

It's time we start setting the same standards for our health care system. There's a good chance you will eventually need it -- and wouldn't you want the same access, information and control you have when investing?

So let's get back to topic. The Blue Cross Blue Shield Association called upon Congress earlier this month to establish an independent institute to provide consumers and health care providers with information on which medical treatment works best.

Reps. Tom Allen of Maine and Jo Ann Emerson of Missouri introduced a bill that would provide $3 billion over five years to fund studies on drugs, medical equipment and treatments. The funds would be paid for by Uncle Sam, heath insurance companies and large employers with self-insured plans.

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Most important, the research results would be quickly disseminated to both providers and consumers in an understandable format.

I don't know if this institute will ever be created, but my hope is that something, in some form or another, will be, and that other actions will be taken to improve quality, access and affordability.

How would comparative effectiveness research help you -- and your pocketbook? It's pretty simple, really. With a better understanding of what works best, you and your physician would choose more-appropriate and effective care, making better use of your health care dollar. And if quality of care for the population improves overall, then money spent on inefficient care can be channeled to more constructive uses.

With momentum among the government, employers, providers and insurers to do something about this -- and with the presidential debate providing an outlet for that momentum -- I urge you to stay informed, get involved and voice your opinion.

Only when information is widely available and made transparent can a consumer-driven market become a reality. You and your pocket book will be better off for it.

Health, wealth and happiness to all.

Donna O'Rourke joined Weiss Ratings, now Ratings, Inc., in 1999, and is the senior analyst responsible for assigning financial safety ratings to health insurers and supporting other health care-related consumer products including Medicare supplement insurance, long-term care insurance and elder care information. She conducts industry analysis in these areas. She has more than 10 years experience in credit risk management and analyses. Previously she served as an assistant vice president at the Union Bank of Switzerland, where she analyzed hedge funds, insurance companies and structured products in support of the derivatives and foreign exchange businesses. She holds a bachelor of science in management from Binghamton University and a master's of science in health systems administration from the Rochester Institute of Technology.

While O'Rourke cannot provide investment advice or recommendations, she appreciates your feedback;

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