If policymakers are serious about real patient-centered, consumer-driven health care reform, they should ensure that their legislative proposals embody six key principles:
Individuals are the key decision makers in the health care system. This would be a major departure from conventional third-party payment arrangements that dominate today’s health care financing in both the public and the private sectors. In a normal market based on personal choice and free-market competition, consumers drive the system.
Individuals buy and own their own health insurance coverage. In a normal market, when individuals exchange money for a good or service, they acquire a property right in that good or service, but in today’s system, individuals and families rarely have property rights in their health insurance coverage. The policy is owned and controlled by a third party, either their employers or government officials. In a reformed system, individuals would own their health insurance, just as they own virtually every other type of insurance in virtually every other sector of the economy.
Individuals choose their own health insurance coverage. Individuals, not employers or government officials, would choose the health care coverage and level of coverage that they think best. In a normal market, the primacy of consumer choice is the rule, not the exception.
Individuals have a wide range of coverage choices. Suppliers of medical goods and services, including health plans, could freely enter and exit the health care market.
Prices are transparent. As in a normal market, individuals as consumers would actually know the prices of the health insurance plan or the medical goods and services that they are buying. This would help them to compare the value that they receive for their money.
Individuals have the periodic opportunity to change health coverage. In a consumer-driven health insurance market, individuals would have the ability to pick a new health plan on predictable terms. They would not be locked into past decisions and deprived of the opportunity to make future choices.
And if you’re looking for a nice short podcast on consumer-driven health care, go right here.
If you want a book on this, you can get Regina Hertzlinger’s book (interview here), although I read it, and I found it filled with too many case studies and stories and not enough policy analysis.
It was a bitterly cold night in January when Geraldine Weller gave birth in the car park of a London hospital. Three hours earlier, the maternity unit had sent her away. Midwives who said they were short-staffed had confidently told her that it would be “ages yet” before she went into labour. They maintained that view even as her husband made frantic phone calls, reporting from their Surrey home that the baby’s head could now be seen.
In desperation, the couple ignored advice to stay put and drove back to the hospital. With her husband shouting into the security cameras of the maternity unit for help, Mrs Weller stepped from the passenger seat. As she did so, she gave birth to their first child, catching the newborn in one leg of her pyjamas.
She says: “We just huddled together. My husband came back and wrapped Henry in a bath towel, and finally one of the nurses came out and said: ‘What’s this?’ ”
[…]Last month, a survey of 25,000 women who had children in England last winter found that more than one in five was left alone during childbirth at a point when it worried them.
The rest of the article features eyewitness comments from midwives working within the system. Naturally, no real names were used because the NHS sanctions anyone who speaks out against their government-run health care system. The same kind of government-run health care that the Democrats want in this country.