Some Blog Site

Since my last post on this topic was so popular, I thought I would throw another two cents into the discussion.

There.

But since you couldn’t see the pennies that just went flying, I will type something here instead.

Here are three problems and suggested solutions for lowering the cost of health insurance:

1. Costs are high in part because people don’t have to pay the cost. Think about this: how much would your car insurance cost if you had no deductible and the insurance paid for oil changes, wiper blades, new tires, etc.? That’s the state of medical insurance today. The consumer / patient pays the insurance company one fee and the insurance company takes care of everything. There’s no real incentive for consumer choice.

   I could take the analogy further for HMOs. In that case, you could go to the repair shop that you normally used (your Primary Service Center or PSC) only. If they couldn’t handle your repair, they could send you to another shop, but it would have to be a shop that had an agreement with them. You couldn’t go to just any shop.Would anyone with a car think that’s a good idea? How did medical care get into this situation?

   Make health insurance more like other insurance. I have an HSA in coordination with a high-deductible insurance plan. This, not a government-run plan, needs to be pushed and expanded. I write a check to pay for whatever medical bills I get. Once I spend above a certain amount, then “traditional insurance” kicks in. The country needs more “traditional insurance” and less bureaucracy. There are no approvals or referrals needed for the checks I write, saving both me and the doctor’s office time and effort and money. But this is tied closely to point #2, which is…

2. Costs are high in part because people don’t know the cost. Back to the car analogy… When you take your car in for service, they have to provide you with a written estimate. So you know, before you agree to something, what it will cost. And if something will cost more than the estimate, the shop has to get your consent.

   A good example of knowing the cost is LASIK. LASIK was very popular, so much so that eye places were advertising to attract patients. What’s an important part of advertising? Telling the customer the price! Eye surgeries became commonplace and price dropped dramatically, in part because of the proliferation of the technology and in part because of the price wars among shops.

   Right now, I can choose my doctor’s office based on location or how happy I am with them. It would be great if I could also take price into account. How much does an ultrasound cost? How much does an annual physical cost? Why not require doctors’ offices and hospitals to publicly post their prices? Kind of like a menu at a restaurant… That would help people choose. Don’t Americans like choice?

   We have started using the walk-in clinic in town because they are much faster than the normal doctor’s office. If it weren’t for my high-deductible insurance, I would not be able to compare the prices, because I would never see the prices. And as it is now, I can compare the prices only after receiving service, when I get the bill. In case you’re wondering, the walk-in clinic isn’t any more expensive. And it’s faster.

   It might not be top-quality care, but it is good enough. And isn’t that what is needed: adequate health care for people? You’re not going to be able to provide world-class care for everyone. That would bankrupt the whole country. But you can provide decent medical care. And that means that there will be different levels of care based on price. So let the people know the prices.

3. Politicians are on the outside. Make sure that the politicians who wrote, pushed for, and voted for the bill have to use the same services that the rest of us lowly civilians do. Make them taste their own medicine (pun intended). It would be easy for the Senators and Representatives to prescribe health-care reform and mess up the private insurance industry if they can keep their Congressional health care separate and untouched. Maybe they would think more about the bill (and actually read it, one would hope) and produce a better bill if it applied directly to them.

Maybe these things would not bring health care to everyone, but they would help make it cheaper and therefore make health insurance affordable for more people.

We have the best medical system in the world. Don’t make big sweeping changes and risk ruining it. Make incremental improvements, like these.