The market-oriented way to bring prices down is to give consumers more control of their own health care dollars, like they have in every other aspect of the economy. If you as an individual control the money, you’re going to shop around for the best combination of quality and price. If somebody else is paying for the care, you’re less likely to care about how much anything costs.
The above is from an article on Forbes. Com
It pretty much reflects the conservative view of health care reform. It relies on you buying health care like you shop for a car, a television or a pair of shoes. It also assumes you have the resources to pay large out-of-pocket costs so that you are motivated to “shop.”
Equally important, it assumes you know how to define quality health care and that there are tools available to help you make that assessment.
My opinion is that this is 🍕 in the 🌌
So, here are my questions for you.
1⃣ If you or a family member is ill or already under treatment, do you want to shop for the best deal before you receive a procedure that has been recommended?
2⃣ Do you have the resources to pay a family deductible of $4,000 or more?
3⃣ How do you know you are receiving the highest quality health care possible?
4⃣ What’s more important, the best care or the best price?
5⃣ Are you prepared to be a health care consumer before you are a patient?
6⃣ Do you feel you have the resources and the ability to assess the quality of health care you receive?
7⃣ Are you prepared to make cost/benefit decisions about your health care?
QUINNSCOMMENTARY 
I am only one of almost 20MM Americans with Health Savings Accounts today. No one knows how many more have Health Reimbursement Accounts.
The problem is that many people somehow come to the conclusion that it is OK for others to decide when it comes to coverage and treatment – what coverage I need, which provider to use, etc. You hear it all the time – where others complain that the application of a $10 monthly copay for an Rx or having individuals pay out of pocket for preventive services “denies” access to contraceptives, etc.
Ask the policy wonks. They are all totally certain they know what is best for you, what is best for me. They “gave” us PPACA. They “gave” us Medicare and Medicaid. With the planned and 1/1/15 cuts in Medicare and Medicaid reimbursement rates, fewer and fewer providers will accept those plans. Let them, and the policy wonks will give you more such “solutions”.
And, their solutions are not “dynamic” – they always fail to take into account how those who pay attention, those who have vision that exceeds the tip of their nose, how they will react. Which policy wonk would have predicted that “consumerism” would morph into nearly 20MM health savings accounts back in 2003? At this rate, all Americans under age 55 will someday have an HSA. I expressed it, back in 2004, as: “25 years ago, no one had ever heard of 401(k), 25 years from now, all will have an HSA.” It is the shift from “defined benefit” health coverage to “defined contribution” health coverage. And, in fact, at the current growth rate (coupled with PPACA disincentives to maintain high cost health plans), it is a story coming true.
Personal responsibility is in short supply when it comes to deciding on medical services, coverage and treatment. The policy wonks take advantage of American’s interest in “Dancing with the Stars”, The Voice, Monday Night Football and other such distractions … and preoccupations. Why worry them about coverage, medical services, etc.?
As you have already found out, or will soon find out, whether it is Medicare or Medicaid, soon you and I will have the best health care coverage WE CAN’T USE … as more and more providers leave such contrived systems/processes. Only those of us who take matters into our own hands (as ignorant as we are) will have some semblance of the coverage available today. And, keep in mind, ask Professor Gruber, keep in mind that it won’t be too long into the future when even a HSA-qualifying HDHP will be so expensive as to trigger the Cadillac Tax. The indexed the thresholds at CPI (CPI +1% for 2019, 2020). After 43 years of benefits leadership, you know what management will do, and so do I – few, if any, once the tax is triggered, few management teams will agree to both pay towards the cost of health coverage and to shoulder the Cadillac Tax (as there is no Cadillac tax for those who drop employer-sponsored plans in favor of public exchange coverage).
Myself, I will be on Medicare in 2 years. I just went out and found me a primary care physician who is 20+ years my junior, who treats his own dad, who is about 68 years old. So, I plan to fund my relationship with a concierge fee. Simply, I’m sure to be just as exposed as are today’s 70 year olds beyond my PCP … exposed to the whims of the policy wonks and politicians who use these government supplied/mandated programs to buy votes. I predict, with great certainty, that they will (propose to) increase the taxes I have to pay … so as to buy the votes of others.
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You asked:
1⃣ If you or a family member is ill or already under treatment, do you want to shop for the best deal before you receive a procedure that has been recommended? My wife just had a hip replacement. We shopped for the best practitioner, even though one facet of our choices ended up using an out of network provider – adding about $2,000 to our out of pocket costs.
2⃣ Do you have the resources to pay a family deductible of $4,000 or more? Yes, but only because I have accumulated 15 times that amount in my health savings account during the last 10 years when I and my spouse were relatively healthy (we satisfied the HDHP only three times in the last 10 years that I was participating in a HSA-qualifying HDHP, 2005 – 2014).
3⃣ How do you know you are receiving the highest quality health care possible? I don’t. But, I wouldn’t know that even if I had a plan with no deductible and 100% coinsurance, with no out of pocket costs.
4⃣ What’s more important, the best care or the best price? The “best” care (that which accomplished the intended result with the lowest possible level of relapse, complications, etc.) at the lowest possible price. Inconvenience, such as medical tourism, has a cost as well.
5⃣ Are you prepared to be a health care consumer before you are a patient? I have been a health care consumer throughout the last 40 years… but, just not very good at it. I need to do more preventive work … particularly losing some weight. I stopped smoking 37 years ago.
6⃣ Do you feel you have the resources and the ability to assess the quality of health care you receive? Much more today than in the past, but no.
7⃣ Are you prepared to make cost/benefit decisions about your health care? If I don’t take on that responsibility, who will? Even if I wanted to, who can I outsource those decisions to? Who will stand in my shoes?
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Fair enough, but I’m sure u will agree u are not typical. What bothers me most is the glib hype that consumers can determine quality or make objective decisions or that many will accumulate assets for health care as you have.
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