The New Health Dialogue

^{Image from Creative Commons.}

Ever read a credit card agreement?

Yeah, I haven’t either.

We all know it’s important to understand the terms and conditions attached to these all-important pieces of our financial lives, but credit card agreements are long, boring and full of unintelligible boilerplate legal language. Even if we did read them, whether we'd learn anything is far from certain.

That’s why the Consumer Financial Protection Bureau (the new financial regulator born of the Dodd-Frank Act) has created a new, simplified version of a credit card agreement that is designed to provide consumers with something they can actually read before signing up for the card. The hope is that the documents will become useful tools for comparing different card offers, rather than being the thing you dig through to find out what went wrong when your rate suddenly goes up.

The Creative Commons project has used a similar system very effectively for dealing with its copyright licenses. Each CC license (there are several, allowing different levels and types of usage) is a complete contract, full of legalese and probably incomprehensible to most people. In addition, though, the contracts have “human-readable” summaries that lay out the important differences between licenses, and clearly state what people may and may not do with copyrighted material. The summary states that it isn’t the full license—it’s not a legal document -- and it doesn't lay out all the specific details that might be relevant in some cases, but for most people it's good enough.

Anyone who's ever had surgery, or even a colonoscopy, knows that the legal paperwork in medicine is just as dense as it is in banking--and the stakes are much higher. Given that, it seems like there should be a huge movement in the medical community toward creating human-readable paperwork for patients. The current system is clearly failing: people sign the documents, but the ideal of informed consent is being left behind. In too many cases, patients give consent--but they aren't informed. 

The real goal of the new credit card agreement is not only to disclose the terms of use, but to help customers make active choices among their credit options. Patient decision aids (which we've written about before) are a crucial tool for doing that in a medical setting. There's a huge opportunity to make patients much better off by giving them information that they can use to make decisions. Here's hoping  health care agencies will follow the CFPB's lead, and push hard for patients to have understandable and comparable information about their treatment (and non-treatment) options.