Shopping for Health Care
I missed this article the first time around, but Arnold Kling makes a point that I have been trying to make coherently for a long time: The biggest problem in health care is not under-insurance or efficiency or drug company profits. The biggest problem is the insulation of the consumer from health care prices.
For health care providers, insulation is a bonanza. Because
consumers are not spending their own money, they accept doctors'
recommendations for services without questioning them and without
concern for cost. Faced with an insured patient, a health care provider
is like a restaurant catering to convention-goers with unlimited
expense accounts. The customer will gladly take the most high-end
recommendation and not worry about the price.Consumers are
happy as well. Insulation relieves the patient of the stress of making
decisions about treatment. The patient also does not have to worry
about shopping around for the best price.The problem with
insulation is that it is not a sustainable form of health care finance.
Individuals, employers, and government are all under stress.
Health care plans on the table basically put decision making for a) making price comparisons and b) deciding if a given procedure is worth the price -- in one of two people's hands:
- The individual being cared for or
- The government
That's it. Its one or the other. The current system of "nobody" is not sustainable. To the extent that people have grief about their employer or their insurer, it is usually because the insurer is trying to make these decisions (someone has to) and the individual is resentful that the insurer is not making decisions the way the individual might like. In this context, it is nuts that many people see the solution not as "let individuals take over this decision" but as "let the government do it." I'm sure that will turn out well.
By the way, I have been with a high deductible policy for a while now, and the medical care shopping process is a real eye-opener. I really highly recommend it -- not only am I managing the costs but I am learning more about the care itself. For those of you who don't want to price compare, Michael Cannon of Cato makes the very good point that everyone does not have to price shop - only a few people need to for all of us to get the benefit. I never even look at the price of toilet paper, but I know it is probably a good price because there are folks out there who DO compare.
Oregon State Climatologist George Taylor sends in a picture of one of the official temperature measuring sites that feed into the databases that are used to track global temperature. 

