As health care collapses in Congress, let’s shift focus to prices, not payment

As health care collapses in Congress, let’s shift focus to prices, not payment | Truth in Health CareAre we reaching a tipping point in the discussion of health care reform? I felt somewhat optimistic about it the other day, after reading a letter from a Kokomo Tribune contributor, Ed Vasicek.

His point? That we’re arguing about the wrong thing. Instead of debating why our health care costs so much, we keep debating about how to pay for it—in other words, insurance coverage. I love Vasicek’s view of the nature of insurance:

Insurance companies need to make a profit (or at least break even) to exist. They must adjust their rates to make this possible. So, in a very real sense, insurance rates reflect medical costs. Insurance rates rise not so much because the bosses get a humongous bonus, but overwhelmingly because medical costs rise. [Emphasis mine]

Wrongly focusing on access to a broken system

To put things more bluntly, we continue to spend almost all of our time arguing how to provide greater access for our citizens to a broken health system. And, as we have blogged previously, the system is broken primarily because of prices. Former hospital CEO Steven Weissman—someone who should know—has been making this same point cogently in speeches and publications for the past year.

Ed Vasicek thinks the solution is a government-regulated monopoly that controls profits. But, regardless what you think about that remedy, it’s hard to argue with his identification of the biggest problem we need to solve. Just take a look at this slideshow, comparing the cost of health care in the United States with other countries of the world, and you can see what’s wrong. We cost the most. And, for all our hard-earned dollars, we’re getting mediocre care compared with our peers.

Focusing on high prices is our biggest challenge

I’m hoping now, with the apparent collapse in Congress of Obamacare repeal-and-replace efforts, that we can begin a renewed discussion of health care focused on solutions to the real problem. If Ed Vasicek in Indiana has figured this out, why can’t the rest of us?

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