As much as we need to deal with health insurance portability, pre-existing conditions, and the millions of uninsured, the biggest problem — the one we absolutely must address — is rising health care costs. Every health care system in the industrialized world is struggling with this. No plan — be it a "public option," a co-op, or single-payer — can survive long-term without finding a way to contain costs.
And this billboard made the key to cost containment clear.
What did it say?
Buy one pair of glassesWhat is the one area of health care where you see specials and coupons? Eye care.
Get one free
We see price competition on eye care because most of us don't have insurance to cover that; we pay for it out of pocket. Some people can get their expenses reimbursed from a pre-tax health savings account, but just about everyone has to put out their own money at some point in this process.
What's the result?
When people are concerned about costs, so are the practitioners. From 1986-2003, inflation for all consumer goods was 66%. For health care, it was 150%. For eye care and glasses, it was 56%. (pdf)
How would we apply this to general health care? Let health insurance be like every other kind of insurance -- coverage for unforeseen catastrophes. Pay for regular, predictable health care with health savings accounts that belong to the patient. When patients lay out cash for every medical procedure, they become acutely aware of and concerned about costs, and when the patients become concerned, the clinics and hospitals will too.
Wouldn't that be disruptive to our health care system? Not nearly so disruptive as having costs continue to sky rocket. And we don't have to do it all overnight; we can ease into this.
But what we cannot have is any system that makes health care continue to appear free to the user. That is a recipe for bankruptcy.
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