What would happen if everyone was required to spend up to 10% of their salary out of pocket on healthcare before insurance kicks in?This would apply to everyone making 300% over poverty. And of this group, how many actually spend over 10% out of pocket on healthcare? A fraction. These stats are hard to find, but I’d wager that 80-85% of people could spend less than $5,000 per year on actual healthcare usage. If you make $50,000 a year as a family, you spend $5,000 out of your own pocket on healthcare before you give your case to some outside entity known for managing care badly. If you make $1 million a year, you spend $100,000.
A few things would happen:
- Doctors would want to be found by you. They would be advertising to you like opthalmologists advertise LASIK and plastic surgeons advertise breast implants.
- Many more doctors would go into primary care because they have the potential to make a decent salary and not be slaves to the insurance companies.
- Searching for tests and doctors would become transparent. If Quest didn’t publish their prices for a blood test and LabCorp did, the vast majority of people would choose the comfort of knowing ahead of time how much a test costs. Same for radiology.
- You could search for the real costs of anything you need.
- Patients would stop being kicked around like the link above shows. Patients would stop being a third party that stands in between the business relationships between insurance companies and physician groups.
- Healthcare would become a much more pleasurable experience like going to a spa, an acupuncturist, a veterinarian, or the Genius Bar at the Apple Store.
Ultimately, patients would be in control. The majority of people would have a pleasant healthcare experience that currently doesn’t exist today, much like buying an Apple at the Apple Store. And when you break, fixing yourself would be like going to the Genius Bar.
Critics will say that our nation’s health will suffer if patients have to pay for it. I’d say the main problem is then what healthcare offers. Does healthcare offer something people value as much as their TV, phones, computers, cars, and McMansions? If people don’t value something because they don’t see the value in it, they won’t pay for it. I personally wouldn’t pay for the shitty healthcare experience offered today either. I would pay for no waits, a solid relationship with a smart, friendly doctor that’s all wrapped up in an experience centered on my satisfaction. The fact that this is not offered stems from the historical insurance/doctor relationship.
Doctors need to take back the relationship. Patients need to demand a different relationship.
Healthcare will not change unless patients stop being pawns and become true consumers. Every time you demand “the best benefits” from your employer, you are prolonging your own misery and contributing to the sickness industry problem. You should be demanding the freedom to be a true consumer. You should be demanding the freedom to be treated well. You should be demanding a healthcare experience you value.
Jay cuts to the chase again! Sometimes, it takes drastic thinking to cause incremental change and the reality is that most people will not change unless they are left with no other alternative.
What if what Jay proposed happened? Think about the simple and significant impact that kind of public policy change would have across the entire healthcare eco-system.
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{ 2 comments… read them below or add one }
This is a very interesting perspective and view of the preventative care approach. However there is still the question of how would this approach to health care benefit the population that fall under the poverty line?
I offer this quotation by Eva Mor in conjunction with your view, “What we need in a health system is uniformity in pricing for procedures and services and modalities of provision of testing and procedures for diagnosis and treatment. By providing coverage to the uninsured, which initially will cost the taxpayer, it eventually will save us hundreds of millions of dollars.
As of today, we are paying through our health insurance and our taxes for their care. When the uninsured seek health care, they come to the emergency room, either acutely ill due to waiting too long before seeking help, or bringing in a child with a runny nose and a cough. This is the most expensive mode of health care delivery. If those people were cared for by family doctors, it would cost the system much less.” http://www.ourblook.com/component/option,com_sectionex/Itemid,200076/id,8/view,category/#catid107
The insurance industry certainly is a major part of the problem, however a preventative approach to health care is also greatly needed. However, allowing doctors to market themselves like plastic surgeons could be as potentially harmful to the system. Regulating health care is a very touchy subject, because we are a free market society, however health care, though in many ways is a profitable business, needs to be reevaluated. At what point is health care a business and at what point a necessity, holding it more accountable to fair pricing for the poor, the rich, and the middle classas?
Mr. Maguire,
Thank you, thank you for adding a clear and constructive opinion that lends itself to more thought around preventative and price-leveling of Provider fees!
Any and all conversation around this notion of patient accountability and getting people engaged in how they spend their money is both worthwhile and needed. Obviously, there is NOT a single, broad-brush approach that will fit all scenarios and a Consumerism Model generally only fits those non-acute, recurring, and usually out-patient/Rx type of expenses… acute/inpatient type of care would/should lend itself to a “Bundled” or outcomes type of reimbursement and I hope to see Wellness types of services (A1c labs, preventative screenings, chronic disease support/maintenance types of services) presented to patients/employees as free or nearly free so as to remove barriers for people to embrace the “right things to do”.
There is no clear answer in this dialogue as to what will work, but I was very appreciative of your comment because the only way to move forward is to look at and embrace more obvious and simpler/more direct methods of improving the value exchange between patients and their Providers of Care.
christopher