It?s nice to be able to write something positive about TIME?s ?Curious Capitalist? column. Perhaps the replacement of Justin Fox with Barbara Kiviat plays a role in my about-face.
Kiviat displays an awareness of the valuable role prices play in health care, as in most transactions:
Congress has overhauled the industry, but the revolution has largely been about increasing access to health care, not simplifying it. We are left with the same opaque system of perverse incentives–paying providers for more tests and procedures, not necessarily effective ones. And we lack even the most basic element of the free market: price information. I recently went to a doctor and asked how much my office visit and X-ray would cost. Staffers told me that they didn’t know and, since I have insurance, I shouldn’t care.
I should care, though. In fact, I do. There are many reasons health care costs are spiraling out of control, but the simplest one to understand is this: nobody knows what anything costs. Providers get paid through a tangle of insurance-company agreements and billing schedules that change from patient to patient. No wonder a hospital can sneak a $100 box of Kleenex onto your bill and the price of an MRI can range from a few hundred to a few thousand dollars. If you don’t know what something costs, you can’t know if it costs too much.
How should we address the challenges Kiviat describes? By increasing government involvement in the health-care sector? No. The answer lies in consumer-driven health care, as Joe Coletti discusses below.