Imagine buying a $7,500 car blind — without knowing how it compares to other models, how well it’s made or how fuel-efficient it is. Most of us simply wouldn’t do it.
But that’s exactly how we buy health care. Americans spent an average of $7,421 per person on health care in 2007. Yet when we buy health care, most of us know almost nothing about what we are likely to get for the money.
We don’t know how well our doctors or hospitals perform compared to quality standards put together by authoritative national medical groups. Those numbers exist, but we don’t ask — and we’re not told — about the quality or value of care we receive.
In Missouri, there’s no requirement that doctors and hospitals report that information. In fact, they can prevent it from being released publicly.

Some Missouri lawmakers are trying to change that. They want to allow insurance companies and business groups to collect and release data on quality and affordability. That would allow consumers to make better decisions about health care, just as they now do about buying cars or other products.
But the effort is facing stiff opposition from some health industry groups. Hospitals are making technical arguments to limit reporting on quality and prevent disclosures about affordability. They want to limit reporting to a narrower set of quality standards that contains nothing about value.
Hospitals already collect a great deal of quality information. But most of it is not released publicly. At some hospitals, the information is not even shared widely within the organization. That defeats the purpose of gathering it, which is to improve care.
Missouri House Bill 497 would have changed that by requiring public reporting of what are called “adverse events” — mistakes such as operating on the wrong body part or giving the wrong medication. Those kinds of errors must be reported publicly in 26 states, but not in Missouri or Illinois.
House Bill 497 is going nowhere. So its backers are trying another tack: They added a so-called “transparency amendment” to another health care bill.

Insurance companies have access to cost and effectiveness information because it’s part of the medical claims filed by their customers. Some large Missouri hospital systems insist on putting language in contracts with insurance firms that prevents them from releasing information on, for example, how often heart attack patients at a particular hospital get recommended treatment and what that hospital charges for that care.
In some cases, data show one hospital charging considerably more for the same procedure than others, even though the higher-cost hospital actually scores worse on quality measures.
But because of restrictive contract provisions, insurance companies can’t release that information to their customers. That prevents market forces from working properly to reward high-performing hospitals and punish those that don’t do as well.
The transparency amendment would prohibit restrictive contract provisions. Unfortunately, the amendment has been added to a clunker of a bill, Senate Bill 306.
SB 306 would expand insurance coverage to about 35,000 working poor parents, which is good. But instead of building on Medicaid as Gov. Jay Nixon proposed, SB 306 would create an alternative system with higher overhead and more restricted benefits.
The best solution: Pass Mr. Nixon’s Medicaid proposals, and resurrect and pass HB 497. Medical consumers have a right to know what they’re paying for.