American consumerism is a force to be reckoned with. Turn a few hundred million of the world’s most sophisticated shoppers loose on an industry, and watch companies scramble after their business. In realms from washing machines to stock trades, quality goes up and price comes down as companies look for an edge over the next guy to win customer dollars.
Not in health care. Congress has overhauled the industry, but the revolution has largely been about increasing access to health care, not simplifying it. We are left with the same opaque system of perverse incentives–paying providers for more tests and procedures, not necessarily effective ones. And we lack even the most basic element of the free market: price information. I recently went to a doctor and asked how much my office visit and X-ray would cost. Staffers told me that they didn’t know and, since I have insurance, I shouldn’t care.
IT’s time for these concepts to leap off the page and become reality? We know that we spend far too much for insurance, especially in NY where there are rules that states that everyone pays the same premium…so a 20 something healthy individual pays the same amount as someone who visits the ER or is admitted to the hospital every other week. 10% of people are responsible for 90% of health care expenses. We need to open up insurance options across state lines, we need to envision and IMPLEMENT plans that allow the healthy 20 something to maintain catastrophic coverage on the off chance they may need to interface with a hospital for an unforeseen accident, etc.
Who is going to step up to the plate? Who is going to implement the kind of premium reforms and payment reforms necessary to enable us to have a sustainable, efficient and affordable health care market.