In health care reform, what you don’t know can hurt you. Quality of care varies widely from provider to provider, and access to meaningful, objective information about those providers remains highly restricted in the United States. That may explain why U. S. health care results are the worst among all the world’s developed countries, according to multiple independent sources, including the World Health Organization.

There has been a great deal of acrimony and debate about how health care reform will work and who will pay for it, but there’s been remarkably little debate about how to measure quality even though hundreds of pages in the health care bills before Congress focus on that issue.

Current reform bills would allow providers and insurers to be judged only when they want to be and usually by organizations they strongly influence or control. For consumers and taxpayers, that’s bad news.

Transparency in the U. S. health care industry has been moving at full speed in reverse. Lobbyists have worked overtime for several years to regain control of consumer data and thwart the Freedom of Information Law that gave consumers their only real peek at what’s been happening in the system.

Transparency took a major step backward in 2005 with the Patient Safety and Quality Improvement Act. This law undermines Freedom of Information laws by allowing providers to hide data about mistakes and makes it a federal crime to disclose such mistakes without providers’ permission.

The federal government took another giant step backward when it began relying on industry-dominated, “consensus- based” entities such as Chartered Value Exchanges to circumvent Freedom of Information laws that allow consumer watchdog groups to evaluate providers’ performance. Legislation requiring industry consensus before consumers can see health care data opens the door to providers and insurers to create gridlock whenever they don’t want to share information.

Some states like Connecticut have long resisted letting consumers know the score. These states eviscerate Freedom of Information laws by letting state hospital associations decide who should have access to information about hospital quality. That is why myHealthFinder.com joined 50 newspapers and filed a Freedom of Information request to bypass those barriers and get the data directly from the federal government.

To be effective, transparency reform bills must define comprehensive provider disclosure requirements and robust databases that are subject to this nation’s Freedom of Information laws. If current reform proposals are not improved, the foxes will be in charge of the henhouse. The health care and insurance lobbies will decide what information you see and we will never know if reform is working.

Bruce A. Boissonnault is president and chief executive officer of the Niagara Health Quality Coalition.