Quote:No problem. In America, the vast majority of people have health insurance through their employers. This creates another layer of bureaucracy between the service provider and the consumer. Ultimately, it is the consumer making decisions in their own best interest from a diverse constellation of goods and services that provides the best mitigation against cost and the best insurance of value. As it stands now, Doctors don't really have to worry about attracting individual consumers, they just have to worry about being part of a Network. Insurance companies don't have to worry about catering to individual consumers, they just manage large groups. (within these groups is an underlying implied TERM of employment that leads to another actuarial slight of hand, but anyway.) The end result is a system by which most if not all health care providers DON'T REALLY HAVE TO COMPETE! When was the last time you actually asked a service provider how much a procedure will cost? And if you did ask when was the last time you got a straight answer? The entire office staff is, however, drilled on what guidelines must be met in order for a procedure to be COVERED.


This second decoupling of the consumer from the service provider happened as a result of the government trying to implement WAGE CONTROLS during the second world war. In order to attract NEW TALENT companies started offering HEALTH INSURANCE as a way around the WAGE CONTROLS. The employer based system was then essentially codified into law by the tax code. Employers get a write off, individuals don't. That makes NO SENSE!


Historically Wage and Price controls do not work. usually, one of two things happen. 1.) as above, companies just find a way around the artificial controls by just calling it something else or b.) it creates shortages and distortions in the market place that inevitably lead to government RATIONING. That's why in Britain it can take a few weeks or months for some diagnostic tests, while here M wife can get a referral from a morning doctors visit to get an MRI that afternoon. That kind of freedom can lead to more overall spending within the health care system that can make total costs look inflated on a balance sheet, as you alluded to above, but the alternative of limited access doesn't sound all that appealing when you think it through.


Ultimately, the more choices the consumer has the better. When you go into a store they don't hide how much a gallon of milk costs, they don't hide the cost of a porterhouse. This allows people to make the best decisions for them given their circumstances and set their own priorities. This also gives the grocers incentive to keep costs in line so they can attract more consumers. But allowing them the flexibility of controlling price allows ALL PRODUCERS to respond to real market forces of scarcity or abundance so that there's still food on the shelves for us to choose from. In healthcare, we have to a.) increase the amount of choices that consumers have, and give them more control over how dollars are allocated to reintroduce price competition to a system that currently thrives on large pools of employees that will be part of a network just by virtue of signing on with a w-2