An analyst at a free-market think tank has come up with a list of changes in U.S. laws and regulations that could make the health care market friendlier toward health savings accounts and other personal health accounts.[@@]

State and federal lawmakers should encourage qualified doctors to auction their services off through Web sites, according to Derrick Herrick, a senior fellow at the National Center for Policy Analysis, Dallas.

Policymakers also come up with malpractice standards for e-mail consultations, so that doctors feel free to communicate with patients through electronic mail, and policymakers should further encourage doctors to sell their services through the Internet by easing restrictions that now require doctors to see patients face to face before making treatment recommendations, Herrick writes in a review of the “consumer driven” health care movement.

Herrick points out that at least one Web site, BidForSurgery.com, already is applying free-market forces to prices for plastic surgery, by allowing surgeons and patients to use an eBay-style process to agree on fees and other terms.

But, because of restrictions on payments for physician referrals and characteristics of the mechanisms patients usually use to pay for medical care, “it is difficult for the Web site to collect fees for [surgeons'] services,” Herrick writes. “Whereas Web sites selling airline tickets receive nominal fees from the airline whose ticket is sold (usually $5 to $10) – and the air traveler also pays a nominal fee – BidForSurgery.com cannot make similar arrangements as easily.”

BidForSurgery.com has no practical way to find out whether a patient actually had surgery and how much the patient paid the surgeon, and current restrictions on referrals limit the site’s ability to charge surgeons for patient referrals, Herrick writes.