June 06, 2020
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Comments for: Let the buyer beware in a free-market health care system

  • Anonymous

    It is not just the myth of sanctity in free markets that keeps us from affordable and higher quality health care. The insurance companies exert a lot of pressure, and money, on Congress and that is a huge stumbling block in changing the system. The insurance companies have never had it so good, and if States regulate and not the Federal government, things will just get better for them. Citizens will suffer, of course. Is this what we want?

  • And again the call for the obvious, Public Option, is made and this time by a health care professional. Sooner or later Washington, and Augusta, is going to see the writing on the wall. And the sooner it’s seen and addressed, the sooner this constant ‘cluster’ is gonna’ get fixed. The big question right now is a simple one, that being who benefit’s from the current insurance syste ? It’s sure not the consumer ! 

  • Anonymous

    Dr Caper, Health care inflation is attributed to 2/3 innovated technology (drugs, equipment, etc.) and 1/3 Patients excessive demand because they are spending someone elses money.
        One third of spending can be controlled by high deductibles for every patient introducing cost consciousness. This would get insurers out of the doctors office and the doctor would have to deal with a cost concious patient as they did before the advent of collective health insurance.
       Because health care has evolved toward the expensive end of the spectrum because of pooled money, political interference, and protection against competition, health care is out of reach financially for many people. Ordinary people will have to be subsidized on a prorated basis with health savings accounts to be able to afford care. This is already being done by General Electric and 17% of large employers, soon to become 50% according to RAND research.  There is enough money in the system to fund health savings accounts. Under this system you will soon see the doctors that over test and over prescribe change their expensive habits or go out of business. Negating “provider induced demand” from doctors.
       40% of all health care spending is in the last year of life. Do you think people spending their own money will spend their last dollar to be kept on life support. I don’t think so.
       The crime of traditional low deductible and co-pay health insurance is the moral hazard of individual irresponsibility. That has to very visible if you get out and about at all. People spending their own money will want to spend it wisely and stay healthy – the missing ingredients from todays system.
       Patients do not need good information in a competitive health care market. They only need an interest in spending their health care dollars wisely and a good gatekeeper doctor with the right information (sadly, somewhat missing in our health care delivery system).
       Another problem of the delivery system is access. Often the only alternative is to use the emergency room because there are no 24/7 urgent care clinics or your primary care doctor doesn’t have an appointment open for two weeks or more. These are correctable problems and will reduce “provider induced demand” at the hospital level.
      Rand research says people with high deductibles can save between 20 and 30 percent on their health care costs. I have recommended this approach, with Health Savings Accounts, since 1979, and it finally appears to be happening. With better rules governing health insurance, and a newly structured delivery system toward cost effective care, how would you view the coming competitive health care system that RAND says will be here in 10 years?

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