Is it possible to represent and present prices in a transparent way?
One can argue that most plans and approaches obscure pricing and that little substantive progress can be made without a more standardized pricing approach.
Is it possible to represent and present meaningful quality metrics?
Early attempts are that - early. They are bounded by limitations in the type of data collected, by the difference between the available data and how an individual describes "health" and the lack of longitudinal information essential for long-term approaches and measurements.
Will affected individuals understand what is presented?
Consumers believe price and quality information is important but find the current resources inadequate.
Will they change their behavior?
There is evidence that early hospital quality metrics do not change behavior but that pricing changes - particularly in prescription drugs - do change purchasing decisions.
Can the process be continually improved and simplified?
Some argue that our limitations in data will lead to a "dead" end and that further progress will require a re-thinking of the role of consumer judgement, health, and the very type of information collected to represent health and behavior.
Can the effort start small with ‘quick wins” and evolve to realize its larger aspirations?
The challenge is to find a population or area where self-pay markets predominate and pure competition over the right things is taking place.
What kind of coalition can foster the community-wide commitment required for long-term success?
There will be some parties early on who "win" and others who "lose." Success requires all to realize the failure of the current system - something difficult to do since by and large the majority of the population is satisfied with their health care as it is today.
