I agree that there is much wrong with our current system. But that system has developed as a hodgepodge series of government interventions and private sector compensations that has lead to our tangled, skewed, overpriced mess. In normally functioning economy technology will increase the efficiency and quality of product/service. First I think it should be pointed out that there is no utopian perfect system where everything will be bunnies, roses, and ice cream for everyone. Some will ALWAYS have more or better than others.
I posit that the cost is so high and going higher do to government interventions in the market, starting with Medicare 50ish years ago, then HMO/PPO creation in the 70's. These things and taxation caused employers to find other ways to compensate employees (health plans). These health plans have become so endemic and inefficient but folks will continue using them because they are paying for them even though they are getting worse and worse. Here is the link to an article from back in ’93 which discusses much of this history. http://findarticles.com/p...
The answer in my estimation is real free market healthcare. For some meat and short term transition I would propose something like the following.
Those who want the added protection can purchase high deductible catastrophic health plans, voluntary risk sharing. Then perhaps give tax deductions or credits for health care pretty much up to said deductible. This would put onus of the everyday healthcare costs back on the patient where it belongs, which would make them more price/quality conscious. Doctors too would have to start competitively seeking those patients through better pricing/service. This system probably would also decrease bureaucratic overhead, which would also contribute to lowered prices.
Market pricing discovery would occur and competition would start driving down costs. Doctors then would also begin using technology not as another thing to bill insurance but as a means to more efficiently treat the patients so that they stay in business. Those docs that don't do good or don't actually try to fix the problems would be more likely to fail as clients would seek care that worked instead of more symptom care. Both patient and doc would be rewarded for good quality moderately priced care. As things become more patient focused I also think there would likely be an increase in the amount of charitable/discounted care for the poorest but that is certainly debatable.
For fullness I need to note that tax deduction/credits for medical expenses probably would incentivise some to seek more care than they otherwise would depending on the structure of the credits/deductions. But as it is now patients are not rewarded for being price conscious (in regards to insurance copays and such) and doctors are financially incentivised to bill for procedures (more procedures = more insurance money) instead of actually getting client better.
This is my perspective as a health care provider. Please discuss, critic, and share.
Shannon Grimes, D.C.
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