A True Free Market Healthcare System

Medical Economics published an editorial response by Craig M. Wax DO to the people that hammered his original article.   I thought it was so good that I had to show you it here:

We have not had a true free market for healthcare services or insurance in more than 60 years. Previously, patients paid physicians and other healthcare entities and were reimbursed for major medical issues by their insurance. Physicians individually set prices as necessary at a competitive rate of a few dollars for a visit or patients could barter with their own goods or services.

Healthcare list prices are inflated and unrealistic. Most payer entities have deals that cut the price significantly. Only the self-pay patient gets the full list-price bill sent to collections for payment. Such patients should get the best price because direct payment eliminates the middlemen and preempts costly coding, billing, and appeals.

I agree with Dr. Kleinman that the current solution is not working for the 15.1% of the population below the poverty line. I would, however, go further to say that the current system is not working well for any party, except the insurance industry; their stock prices and chief executive officer salaries keep rising. Government and insurance companies increasingly are intimately involved in the patient-physician relationship, artificially modifying care decisions with administrative verifications, pre-certifications of tests, prior authorization of medications, retroactive denials of care payment, etc. We all agree that the current healthcare environment does not work to improve patient involvement in his or her own health self-maintenance or healthcare option decisions.

A true free market healthcare, patient health-freedom, and major-medical insurance reimbursement environment would succeed with no government oversight or startup and maintenance expenses.

People will make better choices when directly responsible for the risks and benefits—and associated costs—they experience. They must be free to make lifestyle choices and choose healthcare options, insurance plans, etc., based on their value systems, because their health is their responsibility.

People should be able to purchase low-cost, high-deductible major medical health insurance plans across state lines with tax-free health savings accounts, as individuals or groups. These insurance plans must reimburse patients based on their health and healthcare choices, not provider networks or artificial administrative processes that are designed to deny care options and ultimately drive up care costs.

Unlike the current employer/employee sponsored system, an individual or group system would remain in effect through job changes and other work-related issues. Insurance companies should compete across state lines to offer people direct health insurance plans that meet their needs, value systems, and cost structures.

All aspects of healthcare—from physicians, labs, hospitals, pharmacies, and pharmaceutical companies to insurance companies—must compete in the free market to provide an efficient and economical environment for patients to exercise their health freedom free will.

For the population that lives below the poverty level, they too must be invested in their own care and self-maintenance. Perhaps the taxpayer system should provide minimal coverage for their major expenses while they shop in the competitive marketplace for their healthcare needs and self-maintenance wants.

Another option, the Zarephath clinic model, as detailed by Alieta Eck, MD, could replace the expensive and unsustainable New Jersey Medicaid system. The plan proposes that doctors of all specialties care for the poor in or through nongovernment free clinics. In lieu of pay, the state would protect the physicians from malpractice claims.