The secret ingredient is freedom.
We have seen the future of health care, and it works. If we let it.
It’s a race against time. Now that the Supreme Court has upheld the president’s controversial health care the law by a single vote, the Obama administration is rushing to ensconce it before Congress can successfully repeal it. Meanwhile, a quiet revolution is underway — one that provides yet more powerful evidence that we don’t need government health care, because freedom works.
Obamacare doesn’t take full effect till 2014. So most of us are still free, for the moment, to make medical choices for ourselves. And we have been doing just that — voting with our feet and our wallets for what we really want: patient-centered care.
Now, not a moment too soon, comes evidence that we, the patients, are doing what no bureaucracy ever can: We are “bending the cost curve downward,” while improving the quality of care.
That’s right. We, the patients, are solving the “health care problem,” all by ourselves — from the bottom up — in the very shadow of the impending government takeover.
This is big. It’s a revolution, in fact. And it’s another reason why Obamacare has to go.
This new revolution is happening because of a recent, significant rise in consumer-driven health plans (CDHPs) and Health Savings Accounts (HSAs).
A CDHP is a health insurance policy that has a high deductible, the amount you pay before your insurance kicks in. The higher your deductible, the more incentive you have to be a careful consumer. CDHPs cost less than traditional insurance plans.
An HSA is a tax-advantaged account that helps you cover your deductibles and other out-of-pocket health costs.
A decade ago, almost nobody had either of these things. Today, a remarkable 28 million Americans, or roughly 9 percent of us, have a CDHP; and 13.5 million Americans, or about 5 percent of us, have an HSA (which under current law must be paired with a CDHP).
Together, these options are turning millions of patients into consumers, helping them take control of their own health-care destinies.
New government data shows that this shift is measurably slowing the growth of health care spending. In 2007, national health expenditures rose by 6 percent. In 2008, they grew by a more moderate 4.4 percent. In 2009, by 3.9 percent. In 2010, by 3.8 percent.
Incentives work. Thanks to the rise of “patient power,” more and more people are asking their doctors critical questions about costs and affordable alternatives. And that, in turn, is putting downward pressure on prices — and upward pressure on quality.
We’ve long known that cosmetic surgery and laser eye surgery are the only two areas in health care where prices continually fall while quality continually rises. They’re also the only two areas not covered by insurance. That, of course, is no coincidence.
Now we’re starting to see patient-centered care at work throughout the health-care sector:
- Many doctors’ offices — 5,000 of them, by one recent count — have switched to a “direct-care” or “highly attentive physician” model. Subscription-based rather than insurance-based, this model enables a doctor to take the time he used to spend on insurance paperwork and instead spend it caring for patients.
- At a growing number of wellness centers like Personal Edge and Executive Health Exams International, doctors spend as much time with patients as they need, instead of the typical 25 minutes, and in settings that are “more day-spa than doctor’s office.”
- A new generation of hospitals and clinics has appeared that specialize in treating just one ailment: cancer. Often boasting four-star service in settings that are “more home than hospital,” these facilities offer state-of-the-art technology and better outcomes than can be obtained in traditional full-service hospitals.
- In most industries, prices are posted; but that’s not true in health care, where patients are not the real customers, their insurers are. Now that’s changing, as more patients pay cash. CareSpot, a chain of 30 walk-in urgent-care clinics in Florida, posts its prices to help it compete directly with overpriced doctors’ offices and overcrowded emergency rooms. CareSpot is booming, with plans to open another 15 clinics by the end of this year.
These signs are nothing less than glimpses of the patient-centered health care system of tomorrow, a system marked by less waste, lower costs, shorter wait times, more comfort and convenience, and greater access to new therapies.
Unfortunately, this revolution is doomed under Obamacare, which basically outlaws CDHPs and HSAs, starting in 2014.
To prevent that, we must repeal Obamacare in its entirety.
And to accelerate and ensconce the new revolution, we should expand Health Savings Accounts, remove barriers to the interstate purchase of health insurance, repeal Medicare’s individual mandate, and make medical expenses fully tax-deductible.
We face a stark choice between two possible futures: Obamacare versus patient-centered care, government versus freedom. The latest evidence confirms that only freedom works.
Dean Clancy, a former senior official in Congress and the White House, writes on U.S. health reform, budget, and constitutional issues. Follow him at deanclancy.com or on twitter @deanclancy.
[Originally published at realclearpolicy.com, Jul. 10, 2012. @realclearpolicy. Republished at deanclancy.com.]