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Pioneer Editorial: Health care reform more than price list

President Bush used a trip to Minnesota last week to sign an executive order which he believes will help Americans make better choices for their health care.

The order, signed Tuesday in Minnetonka as part of a health care forum, requires various federal agencies to compile information about the quality and price of health care they pay for, and share that information with their customers and each other.

Labeled "transparency in health care," Bush's order calls for transparency in pricing by directing federal agencies to share with beneficiaries information about prices paid to health care providers for procedures, transparency in quality by directing federal agencies to share with beneficiaries information on the quality of services provided by doctors, hospitals and other health care providers, encourages the adoption of health information technology standards and pushes federal agencies to develop and identify approaches that pro-mote quality and efficiency in health care.

It's a line that has also been pushed by Republican Gov. Tim Pawlenty's administration, that health care costs can be lowered if consumers are given enough information about health care prices and procedures that they can make their own decisions.

That model works well in normal consumer decisions -- such as picking a car or shopping around for the best price of hamburger -- but it's not a methodology that will reform health care.

Even if given pricing and quality information to rank health care providers, are consumers knowledgeable enough to know the difference? When it comes to hip replacement, should a consumer make a decision by price alone? Consumers are not doctors, and should not base medical decisions on price alone or by how many hip replacements a facil-ity does in a year. More needs to go into a medical decision than just clipping cou-pons for who makes the best price offer.

Data needs to be compiled about health care providers, including cost, which certainly will be scoured by health insurance companies. Sharing such data may make providers more competitive, but consumers still should not base their medical decisions on them.

But even a greater concern to us about this model is it has little if no effect in the broad expanse of rural America. A consumer in Minneapolis may look at prices and quality figures for a dozen hospitals and have something to rate by. In Bemidji, there is only one hospital, so that data is meaningless, unless one wants to compare with Fargo or Duluth and factor in the inconvenience and cost of traveling many miles. Such is the case for most of rural Minnesota which is served by only one or very few providers.

The federal government could do more in controlling health care costs if it could negotiate for lower prescription drug prices -- which it is prohibited from doing under the Medicare Part D legislation -- or by holding down the high administrative costs of health care than by putting out a price list.