The U.S. Supreme Court addressed a blow today to nascent attempts to detect the quality and price of health care, ruling that a 1974 law precludes states from needing that every health care claim including their residents be submitted to a massive database.
The discussions were arcane, but the effect is very clear: We are a long way off from having a real picture of the health care spending of country, particularly differences in the way hospitals treat sufferers and doctors practice medicine.
It also means that, for the period being at least, we will remain strongly reliant on data being issued by Medicare, the federal health insurance program for the elderly and disabled, to study variations in health care. ProPublica has utilized Medicare data to study differences in medication prescribing, surgeons’ complication amounts and utilization of services by doctors, but it is yet not clear that Medicare is representative of all health care in the country.
The court’s decision includes a case from Vermont, 1 of 18 states that made so-called all-payer claims databases. Vermont’s law called for health insurers, health contributors, medical services and government agencies to report data on health care costs, prices, quality and utilization of services to the state. That involved employers who pay the charges of their workers’ treatments themselves, and not through an insurance contract.
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