Monthly Archives: November 2013

Ten points you should know about healthcare reform

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  1. An individual should be free to purchase any legal service and product with his or her own money.  This includes healthcare.
  2. Insurance companies should be free to provide any type of insurance they choose as long as it covers legal products and services.  Free market dynamics should determine the feasibility, cost and profitability of such products.
  3. An unlimited amount of money could be spent on health or the perception thereof.
  4. A fee-for-service system of healthcare provides the highest level of service but also is the most expensive form of healthcare delivery.  When a provider of goods or services (a) profits directly from the number and type of those provided, (b) determines for the consumer the necessity of such and (c) sells them to consumers who acquire them with little personal expenditure, the number and total cost of these goods and services shall be high.
  5. Drivers of excessive care other than profit motive include (a) threats to the provider of loss of money, esteem, privileges and licensure and career, (b) lower levels of medical expertise that foster ordering of inappropriate specialty care, (c) consumer demand and expectations, (d) dissociation of payment from service and (e) desire to please the consumer.
  6. In a market sector driven by emotion (such as healthcare) and when there is a large knowledge gap between providers and consumers, the provider has an unfair advantage in all negotiations.  This dynamic is exacerbated by consumer demand to “do something.” Even when a majority of providers have high ethical standards, the combined effects of unethical behavior and insistent demand are large.
  7. When an individual pays for healthcare insurance either directly or through taxation there is a demand for service and expectation of payment when a perceived need arises.
  8. There will always a segment of American society that declines to purchase health insurance either for cogent reasons important to the individual or due to psychological denial or apathy.  Likewise, there will always be those that oppose specific provisions of insurance felt to be vital by others.  Finally, there are local and regional variations in need and demand for services.  Hence, forcing a universal insurance on all is both inefficient and an abridgment of personal freedom.
  9. Governmental regulation of healthcare has increased overhead costs of providing care while decreasing efficiency and adversely affecting satisfaction of the provider and recipient of services. Government funding of healthcare has dramatically increased overall funding thus the size and scope of the medical-industrial complex.  Both have combined to destroy most free market aspects of healthcare.
  10. The behavior of healthcare providers can be modified by rewards, financial and other.  Hence, lower total costs coupled with higher medical and service quality can be achieved and improved by crafted motivations.  However, a different set of problems will arise, some but not all of which are predicable.