Few really like the idea of promoting more government intervention in the health care market.
Most folks who think much about it generally like the idea of getting consumers more involved in shopping for efficient, high-quality health care. Most patients who are actually shopping for non-emergency care probably like the idea of trying to maximize value. Who wants to think that your expensive, wasteful checkup helped send the whole U.S. health care system into an irreversible tailspin?
Even the Centers for Medicare & Medicaid Services (CMS) likes the idea of promoting consumerism when its traditional Medicare funding is involved.
Medicare policymakers hate Medicare Advantage plans and Medicare supplement insurance that close too many of the gaps in traditional Medicare coverage. CMS officials want Medicare enrollees to pay at least some cash out of pocket when they get anything other than routine preventive care, because they want the enrollees to feel a little of the economic pain associated with health care spending.
But the problem with sending consumers out to drive the health care system in the world as it exists today is that the bills patients get often seem to have come out of a random number generator. The patient goes in feeling fine, just to get a little of the basic screenings everyone seems to be desperate for people to get, and walks out with a big sick visit charge.
Go in for a checkup and ask the kinds of questions healthy people ask — What do you think about that mole? Is it normal for my vision to get a little blurrier when I’m 40? — and you can easily walk out with a $400 bill for what you thought would be a package of “preventive services provided with no out-of-pocket cost-sharing requirements imposed on the patient.”
One solution could be that the government could simply set fair prices or create an official price disclosure system.
But, really, why? The government-run price disclosure system probably would be complicated, hard for doctors to use and hard for the government to police in any serious way.