Can the U.S. Slash Healthcare Costs by More than 75% with ONLY Two Changes?

Yes, Yes it can. It’s simple, really, fund the Health Care Savings Account Deductible and as Walmart or Whole Foods, or any other company as a matter of fact, does, put real prices on everything. It’s that simple? What? You don’t believe me?

Look at what Singapore has done with its healthcare system? Wait, what? Singapore is another country and it doesn’t work the way the United States does? That’s ok, look at what Indiana has done. We have the potential to cut spending by more than $2.4 trillion per year across individuals, businesses, and the government. 

What should be the first policy? Put price tags on everything. It’s practically impossible to get prices on labs and imaging. Just recently I made a list of imaging companies in my home state and called them asking for cash pricing for X-rays, Ultrasounds, etc., and it took me several months with consistent calling to get “estimates” of what the pricing is. One estimate, a local hospital provided, “$729 for a thoracic spine x-ray”, and over “$4000 for an MRI chest with contrast!” Am I losing my marbles here? I’ve called other centers, in and out of my home state, where a “thoracic spine x-ray” would cost between $40 and $60. It took me several phone calls and attempts, at times having to set up ‘sham appointments’ to be able to get such estimated pricing. Can you imagine what it would be like for a working parent with children whom may be in need of an imaging study for their child trying to get such pricing? 

Let’s look at LASIK, which, by the way, is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement account and even a limited care flexible spending account! Because such institutions are openly competing for business, providers have figured out a way to make the process more efficient while making it cheaper. In the 1990s, the cost of LASIK was nearly $4000 per eye! The average price these days is around $2000 per eye and you can even get it done for as little as $1000 if you do your due diligence find the best deal! I recently had mine completed for $3500 with state-of-the-art equipment!

Putting price tags will force the existing systems to fairly charge everyone. In our existing system, the charge for the same services differs significantly depending on the insurance one carries. The price tags will also potentially help eliminate the middlemen and women and help reduce administrative costs in our existing system.

The second policy, also known as the deductible security, should do what Indiana did: pair an insurance policy that has an annual deductible with a health savings account that the policy’s sponsor, which can be a private employer or the government, funds each year with an amount equal to the annual deductible. Say, for example, the annual deductible is $5000, then that is what the employer or government entity would fund for the individual or family.  The latter has been instituted by Indiana which has offered this policy since 2007. Despite Indiana offering its workers a variety of health-care plans, the vast majority have opted for the deductible security, under which the state covers the premium and then gifts about $2850, equal to the annual deductible, into each employee’s HAS every year.  This allows each person to have money to pay for any of the out-of-pocket expenses. Because the unspent HSA balance is theirs to keep, they spend judiciously. This is all possible, because people are now motivated to spend prudently.

This sounds good in theory, but what’s the evidence? The evidence is Indiana! The state tracked health-care spending and outcomes for state employees during 2007 to 2009 and it concluded that those who chose the deductible security plan were 67% less likely to go to the emergency rooms, and rather chose low-cost centers, such as urgent cares. They also spent $18 less per prescription! All-in-all this resulted in 35% lower healthcare spending than when the same employees were enrolled in traditional health insurance. With subsequent analyses of the study, the state concluded that such persons were more likely to take part in preventive screenings, such as mammograms, annual checkups, etc. 

What about Medicare for all? Would that help? Recently, Oregon randomized 10,000 previously uninsured people into a single-payer health insurance in 2008, and it noted that the recipients’ annual health-care spending jumped by 36% without any statistically significant improvements in health outcomes!

If your next question is, how would this work in a National level? Our best example is Singapore. It’s the only country to implement the above two policies and is able to provide universal health coverage with excellent health outcomes while spending 77% less per capita than the United States and 60% less per capita than the UK, Canada, or Japan. Despite the fact that the government spending constitutes about half of all health-care spending, as is in the US, it only spends about 2.4% of GDP on health care as opposed to the US government which spends about 8% of GDP!

In this country, despite the bureaucratic control and nonsense our healthcare system is, we have a group of physicians already doing this. Look at Remedy Health at Oklahoma, for example, or AtlasMD in Kansas or Forest Direct Primary Care in VA and you’ll see the transparent pricing. Such physicians are working with their patients and teaching them how to utilize HSA’s with health sharing ministries or high deductible plans, inadvertently mimicking the aforementioned policies. 

References

“RAND Study Summary.” Health Care for All Oregon, www.hcao.org/rand-study-summary.

Flynn, Sean Masaki. “The U.S. Can Slash Health-Care Costs 75% with 2 Fundamental Changes -and without ‘Medicare for All’.” MarketWatch, 17 Aug. 2019, www.marketwatch.com/story/the-us-can-slash-health-care-costs-75-with-2-fundamental-changes-and-without-medicare-for-all-2019-08-15.

https://forestdirectprimarycare.com/

https://remedyhealthdpc.com/lab-fees/

https://atlas.md/wichita/our-fees/

  2 comments for “Can the U.S. Slash Healthcare Costs by More than 75% with ONLY Two Changes?

  1. Pat
    August 21, 2019 at 8:47 pm

    Nice points, good piece 👍

    • Adil Manzoor
      August 26, 2019 at 10:57 am

      Thanks Pat.

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