Confused By Health Care Jargon? We Put One Man To The Test

The state Legislature recently laid out two competing bills designed to rein in health care costs in Massachusetts, and that means a whole new round of health care jargon. Many people are struggling to make sense of it all, so we want to help explain the latest terminology.

Rather than bring in an expert, we've turned to Boston-area stand-up comedian Steve Macone, who joined All Things Considered host Sacha Pfeiffer to review various health care terms increasingly in use.

Sacha Pfeiffer: So, Steve, you've agreed to be our guinea pig because you don't actually know what we're going to do here today.

Steve Macone: Yeah, I have no idea what's going on.

What we want to do is give you a little quiz on health care jargon and see how well you can do defining various terms. You game for that?

Sure.

Maybe you could tell us first how much a student you consider yourself of health care policy and how much news you keep up on in terms of the health care debate.

Uh, I know something sort of happened that is an attempt to make it less expensive.

Perfect, and that probably is where a lot of our listeners are in terms of their understanding of what's going on. So, what would you think a global payment system is?

Uh, you pay with little model globes? Or everyone else pays? A global payment?

Some people call it health care on a budget.

Is anyone not on budget when they're doing health care?

Most doctors are not on a budget. The idea is: why don't we put those doctors on budget and say, 'You have a set amount of money to spend on a certain amount of patients every year. If you stay below that amount, more money in your pocket. If you go above, it might cost your physician practice some money.'

Sounds interesting.

Have you heard about a limited network?

Yeah. I have terrible service for my cell phone.

What about in the health care context?

Uh, a limited network is — I don't know if I've heard of it but I'm going to use context clues and say that maybe it's where there are limits on the doctors or the specialists that you can see.

Exactly.

Which sounds like a great idea because we have the best doctors in the country — in the world, sometimes — in Boston, so why not put limits on who you can see? That's got to be fun, to be like, 'That guy's the best at solving what you have. Go to the other guy.'

And if you have a limited network plan, how do you think that affects what it would cost for you to go see one of those out-of-network doctors?

They'd be like, 'Oh yeah, you can go see him,' because you can do whatever you want as long as you want to pay for it. So I'm sure you could go see that doctor if you had a million dollars, or even, like, $20,000.

What about comparative effectiveness?

That means — oh, words are interesting and hard! Comparative effectiveness means that if two different procedures are both acceptable treatments for an illness, but if one of them costs $20,000 — and I don't know why I keep thinking that's what medicine costs, but it seems like it to me — and one of them is eighty bucks...I'm just making this up!

This is a great answer.

Is this anywhere near?

Absolutely. You're comparing the effectiveness of different kinds of treatments and, as you said, if one costs $20,000 and one cost $80 and they both achieve the same thing, maybe, comparatively...

Like don't use lasers if you can use a little stick?

Exactly.

This sounds like I know what I'm talking about. We're getting dangerously close to me sounding like I know anything about this.

With all these changes going on in health care do you feel any pressure that you need to study up on what all this means?

Now I do, for sure!

After today?

Yeah, oh yeah. I think it's overwhelming.

If you were going to cram, where would you go to study that?

I would turn to one of my best, most knowledgeable friends, Wikipedia, and I would look up stuff. I mean, everybody just WebMDs everything.

Steve, thanks for coming into the studio. You were a very good sport to being willing to do this having no idea what you were walking into.

Thanks. I thought I was going to get pizza or something. Thank you for having me. I have to go Google some stuff.

To see a more detailed list of health care terminology and definitions, go to our CommonHealth blog.