Word is that Republicans are going to repeal health care reform or make significant changes. Of course they will not repeal anything, and “significant” is in the eye of the beholder.
At the same time there appears a growing movement among employers to embrace the high deductible health plan and healthcare savings account concept. That’s where you get to pay a big chunk of your bills in return for a somewhat lower premium on the theory you will be more prudent in using health care if it’s your money (assuming you have the money of course). If you also place money in a health savings account (HSA) and don’t use it to pay your out-of-pocket costs this year, you can save the money with interest (what’s interest?) to be used for future expenses, perhaps in retirement.
Who says life isn’t fair, now you can save for your own retirement income and health care expenses. Planning to retire at age 55 are you? I retired at 66 less than a year ago and I am already seeing my fixed income eroded by higher property taxes, higher health insurance premiums and other stuff I can´t control—-plan ahead folks, retirement is not fun without money to spend, but I digress.
Contrast the US to Germany where I happen to be at the moment (ok, so retirement isn`t so bad, at least in the early years). A family of four pays €218 per month for health insurance (more for a larger family). That’s about $300. You can choose your own doctor anywhere in Germany and the doctor is paid by the state. Doctors make more money by having a good reputation and attracting more patients.
There is no out-of-pocket cost to obtain health care or prescription drugs, no deductibles, no co-pays. Taxes may be high in Europe and physician incomes low relative to the US, but it’s hard to find anyone who doesn’t like their system. Of course, as it’s population ages costs are also a concern.
Americans seem puzzled over who should have more power over health care, the patient, the doctor, the insurance company or the government. The quandary is finding some balance between cost and quality (forget this freedom of choice stuff, quality is the real goal and that does not mean you must have high costs-just someone who really cares about costs).
The key to solving the health care problem in the US to the extent that is possible is to place the right incentives on each party within the system. For example, doctors can’t make more money by simply providing more services, hospitals can’t find incentives in buying new expensive duplicative equipment, patients must not be hampered by costs in seeking necessary care or overutilize health care because of low financial risk…simple huh?
One thing is for sure, leaving the system solely in the hands of the patient and the doctor with no involvement by any third-party will get us nowhere in terms of quality or manageable costs. Republicans seeking to reform health care reform should keep this in mind…and so should Rush Limbaugh and Sean Hannity.
Related Articles
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- Beyond Repeal And Replace (forbes.com)
QUINNSCOMMENTARY 
Thanks Dick for your info, keep it coming.
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Not sure I agree with your conclusion. If we actually left health care to the patient and the doctor without ANY third party, costs would decline simply because now doctors and hospitals would be directly accountable to their patients for their costs. Patients would make value decisions based on the health status they want to achieve. they would select the coverage they want rather than be required to have certain mandated coverage. Providers would compete for patients based on quality and the outcomes they produce.
Of course, that wouldn’t solve the age old problem of who would bear the risk for the catastrophic expenses. Complicating that is the definition of catastrophic expense is different for every patient.
Dick, thank you for raising these thought provoking questions.
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Forgot to put my name on the above comment…
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Larry
My perspective was within the current system where the patient is largely removed from costs. You are right if we could make major changes in the payment structure but I don’t see that ever happening. As a result without no financial incentive for managing costs, there needs to be oversight by a third party. Sadly we are headed to various forms of rationing.
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