GUEST COLUMN: Increased transparency needed

Without offering a defense for my recent speech to the Brainerd community, I kindly thank Dr. Jerry Poland for responding so passionately to its subject matter. I have a great respect for Jerry, who some time ago was my trusted ophthalmologist.

Great towns like Crosby and Brainerd have seen widespread improvement in health care over the years, and, as Jerry pointed out, the health care industry provides employment to a great percentage of the population. They now have better access to better services when compared to the situation of decades ago. But everything comes at a cost. I only hope to accurately educate others to help us all determine from where these increased costs are coming, whether from unnecessary use of technology, frequent medical errors never reported to the public, or inefficient delivery systems paid for by rapidly increasing medical prices which can't be blamed on lawyers.

Fortunately, I see community initiatives pushing for increased transparency in the health care system to reduce the quality variation we experience. Through publicly-revealed results from the Minnesota Community Measurement Project, we see a wide variation across 50 medical groups for numerous measures, including a 25-86 percent variance in satisfactory results for controlling high blood pressure. A local television station recently produced a news story on the differences in hospital pricing throughout our own state. The differences included C-sections ranging from $8,000 to $17,000 and hernia treatment anywhere from $3,000-$9,000, depending on which hospital you seek treatment. In what other field would people be forced to tolerate these kinds of differences?

Unfortunately, what I fail to see are physicians taking collective responsibility for this much needed change in our health care system. I do not deny that good doctors exist, those who put in long hours and weeks, and who truly care about their patients. And Jerry Poland is one of them -- and always has been. But while I realize physicians should not bear the sole responsibility for change, I know they are best suited to determine what change is needed and to implement it well. And I challenge them to do just that.

DAVID DURENBERGER is chair of the National Institute of Health Policy and served as Minnesota's U.S. senator from 1978-1995.