As my father likes to say, healthcare analysis is extremely simple: Cost + Quality + Access. You can control two out of three…never all three.
At a 30,000 foot level, the United States chooses Quality and Access over Cost. Quality is largely unfettered; but Access and Cost are moderately controlled, with each being the trade-off…
Emergency rooms do not turn anyone away; but because an ER visit is typically the last resort, the fact that the US is not a universal insurance coverage country acts as a de facto governor to access.
Insurance: Universal Coverage v. Free Market
As with most political topics, healthcare should be a bipartisan issue. Instead, it is Universal Coverage Bernie Sanders v. Free Market Paul Ryan. Both are morons.
100% Universal Coverage means unfettered Access and an explosion in Cost. As Cost skyrockets, the US healthcare market would have no choice but to lower the Quality of care in order to tame the rise in Cost.
100% Free Market means anyone without a job loses Access to the healthcare system outside of ER visits…
…And if the US healthcare market as a whole – not just insurance – went 100% Free Market, the uninsured would lose Access entirely, as hospitals would refuse to accept those without insurance.
In descending order of priority:
- Make healthcare consumers accountable
- Clean up the system
- Expand Medicaid & Medicare eligibility
(1) It is verifiable fact that when consumers of any product or service ‘see’ money coming out of their own account, they behave differently. If going to the doctor for the sniffles means $100 or $200 coming out of the HSA account, consumers will at minimum think about making that visit. If all a consumer must do is present a government insurance card, there is no thought or analysis required for a ‘sniffles’ visit.
Whether insured thru an employer, Medicaid or Medicare, every single US healthcare consumer should see money coming out of an account.
(2) Thru my work in the investment industry I have seen the length to which free market capitalists are legally able to go in order to extract profit from the US healthcare system. I would put 110% odds on the likelihood that I have seen only the tip of the iceberg…
Donald Trump says he wants to “drain the swamp” in Washington. Again – 110% odds that the D.C. ‘swamp’ pales in comparison to the US healthcare swamp.
Cleaning up the system would create transparency, foster competition, and simplify the consumer experience. In today’s day and age of digital technology, the process of shopping for healthcare services should be no more complex than shopping on Amazon. The end products and services are obviously more complex than those found on Amazon…but consumers should be able to compare and contrast doctors, procedures and products in their local area with just a few clicks and swipes.
(3) We have to keep the Socialists happy. So after opening up and simplifying the ‘system’ – which includes Medicaid & Medicare – we must expand these programs for the uninsured. But again – my friend under the bridge and my grandmother playing Words With Friends should both have a healthcare funding account of some kind, so that each and every time they purchase a healthcare good or service they see the money leaving their account.