Stanley Feld M.D.,FACP,MACE
With Medical Savings Accounts notice what could happen when you put purchasing power in the patients’ hands. You give patients the incentive to spend money wisely.
Some patients are going to make good medical care decisions. Some patients will make poor medical care decisions. If the patients make poor medical care decision and do not purchase necessary care they will get sick and even experience complications of chronic disease. They will not only lose the money in the trust accounts for that year, they may lose their health. Patients would now be in the position to be responsible for their health care decisions. The decision would not be a bureaucratic and politically influenced decision.
Patients would be the principle buyers of their healthcare, not the insurance industry, the employer or the government. Patients would have the opportunity to compare prices and options for their own medical care
Physicians would be relating care and price to the patient and not to the third party payer. Hospital would no longer be making deals with the insurance industry and the government. They would once again be competing for patients by lowering prices and increasing quality of care.
The insurance industry would have to change. It would have to provide true insurance for expensive illnesses. They would provide insurance coverage for illness costing more than $6,000 in one year. Presently the insurance industry is an industry that owns patients, owns their insurance dollar, and decides the patients’ needs. It tries to control the physician and the hospital.
The employers would provide the money for the trust account and the high deductible policy. The patients would manage the first $6,000. The employer would help the employee pick the best high deductible policy. The employer would also help the employee make informed purchasing decisions.
The government would no longer be the buyer of last resort. It would provide subsidies for senior patients and indigent patients. It would regulate policy for the advantage of the patient. The government would not dictate what the patient should do. The government could create the environment for competitive markets by regulation. If physicians’ services, hospital services and private health insurance would compete for all customers, prices will fall.
We will see the fall in drug prices over the next six months as Wal-Mart rolls the $4 generic plan throughout the country. The government could achieved price competition on a state level by license requirements of price transparency.
I am not the first person to say all of this. However, vested interests other than the patients’ have stood in the way of its implementation. Remember, no one in power likes the balance of power disrupted, even if the system he controls is a failure. Individual interests rule over the common good. This needs to be changed.
There are criticisms and fears of implementing the MSA system. The criticisms and fears all seem lame to me. We will discuss these criticisms and fears shortly.