Higher Education Meets Sick Care

Three of the most resistant industries to change are government, higher education, and sick care. All three seem to have the same problem with pricing their products, being transparent, cost shifting, accounting gimmicks, and waste and abuse. As a result, students, patients and taxpayers pay more out of pocket.

For example, tuition is now a useless concept in higher education, just like the prices you get on the bill from your doctor or hospital are meaningless and irrational.

One education policy expert wants colleges to instead publish five numbers: how much they spend each year on educating each student; the range a family is expected to contribute to that expense, from zero to a maximum; how much a family contributes on average; the range of what a college itself will contribute for each student; and how much the college contributes on average to the total expense for each student.

Patients should know how much they are being charged compared to other facilities and why: a clear explanation separating professional fees and technical fees, a package price for given episodes of care (what is will cost for everything each semester), different pricing schedules based on payer mix (what did you pay for your airline seat compare to the person sitting next to you?) and how much they will be required to pay out of pocket.

All of these things should be available BEFORE any non-emergent or emergent care is rendered. It is what dentists do. It is what veterinarians do. It is what most professional services do. It is what sick care practitioners should do as well.

When it comes to prices, doctors are caring, but clueless. If you work for a state owned or subsidized medical school, you work for government, higher education and sick care. Good luck changing those cultures in your lifetime.