We All Want Healthcare To Cost Much Less — But We Are Asking The Wrong Question
Joe Flower

Not a bad article at all. I agree that fee for service is the Big Kahuna of the problems that cause the USA to waste so much money on health care. And it is generally recognized that Other Pricing Models are required to avoid bankrupting the whole country. But I might raise two concerns.

  1. The article is somewhat deficient on how we would actually attempt to change the course of the “Titanic”. Should the government unilaterally move Medicare to per patient pricing? Should all Providers be required to post / reveal their prices. How do we do this ?
  2. You state

For it to work at all, the insurance has to be spread across everyone, even those who think they don’t need it or can’t afford it.

which is, of course, absolutely true. Everyone needs to be in the insurance pool and the reward for that is that you get the lowest possible cost for all. Win-Win. EXCEPT that this ideal situation happens to be Nothing Like what we actually do currently. Most Egregiously, Aetna makes 604 million in Q3 2016 while simultaneously whining that the ACA is in a death spiral. Truth being, that overall Aetna is doing fine, but that the people in the ACA pool are older (and hence sicker) than those they get from selling health insurance to corporations. Which is to say that in order to get to your “nirvana” of informed conscious health care consumers, the first thing we have to do is de-couple health insurance from employment. You don’t get your car insurance from where work, neither should your employer dictate the type of health insurance you can have. Which is not saying that your Employer should’t contribute to your monthly insurance premium: I’m just saying that your employer should NOT be the customer. . .

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