Consumer-Driven Health Care

Ezra Klein has a nice post about the hard-to-mention problem with drives toward consumer-driven health care — consumers lack the basic competence to make these kind of decisions. That reality gets driven closer home to me every time I have one of my relatively rare encounters with the health care system. To take just a small example, yesterday afternoon I went to my dentist for a routine tooth cleaning. First, the hygenist scraped around with that scraping thing. Then she went at me with some other water-shooting, vibrating device. Then, again with some different scraping tool. It all seemed more-or-less like a correct tooth-cleaning procedure to me. But then again, if she’d stopped five minutes sooner it also would have seemed correct. Or if she’d gone five minutes longer. How do I know she really needed to do the second round of scraping? Or, for all I know, maybe there should have been a fourth go-round with something else.

The experience, morever, certainly wasn’t a pleasant one. But I’m not displeased with that simply because it was, in parts, painful. According to her, the pain was my fault, I’ve done an inadequate job of flossing the gap adjacent to my wisdom teeth. That sounded plausible. But maybe she was lying. How would I know? Are my teeth even clean — how would I know? And this was for the simplest, most common medical service around … but to the customer, it’s utterly mysterious.