Shafrin Reviews Priceless
There has been much praise for this book. My impression is that provides a new vision for how health insurance would work. The current approach where the government funds a larger and larger share of healthcare costs is not fiscally sustainable. I don’t agree with all of Goodman’s points, but his market-driven, deregulated approach does offer an appealing option to the current status quo. I agree most with Peter Orzag’s review of this book:
“There’s no question that today’s healthcare system is littered with distorted incentives and what John Goodman calls dysfunctionality. This book is a call to arms to do something about it. Even if you don’t agree with all of Goodman’s ideas — and there are plenty I disagree with — you should read this book if you want to be an informed participant in the debate over the future of healthcare in this country.”
– Peter R. Orszag, Former Director, Congressional Budget Office.
See entire review at the Healthcare Economist.
Can somebody provide brief, yet detailed arguments on why the health care system can/cannot conform to markets?
Much of the left do not wish to acknowledge that by opening up the healthcare market and allowing competition that we could possibly see costs come down (or stabilize), and quality increase.
Most of our health care expenditures occur in inpatient settings, where patients have few options. This fact is often used as an argument about why markets and consumerism won’t do anything to rein in medical spending. I disagree. If nothing else, having people use an HSA, HRA or their own resources below a high-deductible plan would help eradicate the notion that people should never be concerned about medical prices. If the prevailing opinion was that people are price sensitive, medical prices would fall and providers would compete on price.
I was recently asked by a friend assist in finding a good price for a CT scan. A brief search on the Internet lowered their out-of-pocket cost from $2,500 to less than $400. This took minimal effort – but I knew how to do it. If everyone had to do this, it would have required no effort — because firms would begin to publish prices on their websites and compete on price.
California and Oregon studies on annual price increases for healthcare services are astounding. Devon is absolutely right though, when you’re under the knife it’s difficult to stop the doctor and ask for an estimate. So they hide the cost of increased uninsured patients and poor reimbursement rates in the cost of procedures for the privately insured.
Health care is very dysfuctional, its about time someone points these things out for the public eye to see.
I recently started reading this book and have found a great deal of eye-opening information in just the preface and introduction.
Market reforms are the answer – I think that’s a good starting point for anyone involved in public policy who is serious at making health care more accessible.
@Michelle,
You should direct that question to Dr. Goodman, as he would probably be the best person to give you insightful and logical information.
More and more positive feedback on this book!
There is a reason why he is known as the “Father of Health Savings Accounts.”
I’m reading Dr. Goodman’s book now, and it is an education on the problems of our current system. I’m looking forward to the proposed solution!
Dr. Goodman: thanks for pointing out how we pay for medical care with time. I’d like to share my experience.
A couple years ago some manner of flu went around our environmental lab, possibly that bird flu that wasn’t included in that year’s vaccine. I ran a pretty high fever and missed a couple day’s work. On the second day I realized that I was totally deaf. Since the VA couldn’t see me for a month, my wife called her doctor, and got an appointment for a week later, with a follow up a month later. When she saw me for the second time with no improvement, she scheduled a referral with an ENT who saw me the next day. By this time I had read that some cases of adult sudden hearing loss had been reversed by a steroid injection into the mastoid space, and that’s what Dr. K did immediately, although by this time I was 6 weeks out and he didn’t have a lot of hope that this would help, but that I didn’t have much to lose by trying it.
the takeaway lesson here: Sudden hearing loss = emergency situation. Don’t wait.
Chuck and Devon are only partly right.
Price disclosure and competition will absolutely lower the cost of diagnostic tests and the simpler outpatient procedures.
American who drive 10 miles to save $3 on a tank of gas will certainly drive 40 miles to save $800 on an MRI.
This will destroy the huge profits that hospitals now make on outpatient care.
But here is my caution- since 80% of a hospital’s costs are fixed, what will stop hospitals from yet another massive cost shift over to no-choice emergency care?
So MRI’s will now cost just $400, but if you have a broken leg it will cost you $15,000.
I am not sure if Dr Goodman deals with this. Comments are welcome!