on healthcare costs

The hot topic of the moment, and likely for the next few years unless something drastic happens, is healthcare. The Obama administration is attempting to revamp the insurance system, which is in dire straits. The question is, how to balance quality care with affordable care? The criticism for nationalized healthcare is that it becomes inefficient and slow, and lacks quality. People use Canada as an example. Though prioritization is certainly a problem when you have a lack of doctors and services, quality does not, necessarily need to suffer. This is the argument from the free-market champs who believe that the free-market is the only mechanism that can deliver the best quality. But as we've seen in the auto industry with respect to fuel efficiency, this is far from true. The so called "free-market" focuses on making profits, not delivering superior goods. The latter is only true if you have customers making informed honest decisions based on good information. But because corporations are required to make money, they often use obfuscation and dishonesty to bolster the image of their product. So we aren't operating in an environment where customers can really make informed decisions because they are being duped or expected to be experts in fields that they clearly can't be. (e.g. the recent financial crisis).

In terms of health insurance the problems are deeper because you: 1) don't know how sick you will be in the future, 2) can't understand exactly what you're buying and 3) the cost structures are inherently very complicated with rules about what is covered and what isn't. When you add in the necessity of healthcare, the customer not buying the product isn't really an option (though because of costs, it does happen). This sets up a market that is incredibly difficult to navigate for a customer. Therefore as customers we find ourselves in a position where the insurers want us to engage in "preventive medicine" but at the same time, they won't pick up the bill for such care.

As a future healthcare practitioner, I'm encouraged by examples of doctors who have tried alternative fee structures such as subscription services. For example, a doctor in New York, charges his patients $54-$130 a month depending on their age. They get unlimited access to him and he even makes house calls. He encourages his patients to get emergency coverage, and they have to pay for their own medications. But because he sees fewer patients, he gets to spend more than the disgustingly low average of 15 minutes with his clients. This extra time allows him to really streamline his patients treatments, often reducing the number of medications that they are on to half. This is real cost savings to the patient, and the system as well. Less referrals to specialists, and more patient-doctor interaction is a good thing for everyone.