Interesting article with a number of excellent points. I am still not sure about what I think about having insurance cover the catastrophic (as in over $50,000) and you pay the rest. His idea is that cost would do down. After all, an MRI costs too much and bears no relationship to the cost of the machine and the operator. He compares it to Lasik, where the cost has dropped dramatically because it is not covered by most insurance. But the problem with that comparison is that the MRI might be necessary and the Lasik is not. It is easier to walk away from the Lasik than the MRI. So, you need one. The idea then is that you will shop for the cheapest MRI or skip it. To shop for an MRI in my area I would have to drive 150 miles. And once you are in the hospital or have an emergency you can't shop. You can always shop for Lasik. This doesn't mean that I reject the ideas, but I have concerns.
He does briefly address the issue of people foregoing needed medical care because of cost. He suggests a voucher for a doctor appointment once a year. Well, ok, but what about the prescribed treatment? Physical therapy. Drugs. I did read one study once where people who had higher deductibles on their insurance were more likely to skip treatments. You can say that is a choice and maybe the choice is a even a good one. After all, maybe you don't need the MRI. I think I mentioned once an xray I had of my hands after a compression injury. In retrospect, it wasn't really necessary and I bet I would not have had it done if I had to pay out of pocket. But what if the choice is not a good choice? The problem is that the cost is higher in the end. For example, if you are depressed and don't take your antidepressant and go to counseling, you may be more likely to be hospitalized.
Insulin is a necessary drug. You die without it. But there isn't generic insulin, it is all branded. It costs a lot. Does it really need to cost so much? I doubt it. How many brands of insulin are there? Three companies sell insulin but the products are not all the same. Tough to see how the price will drop.
But worth thinking about and if nothing else the article illustrates the problem of the screwed up marketplace.
Can't think about this more right now--off to the annual library book sale!