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Health Care in the 21st Century
Wiley Long

Consumer-driven health care has the potential to be a

powerful force of change in the health care system. By
instituting competitive pressures, encouraging greater price
transparency, and rewarding consumers who are proactive about
their health, the growing adoption of
Accounts will help make health care more affordable for
everyone.



In an article entitled "Health Care in the 21st Century",
published in the New England Journal of Medicine on January 20,
2005, Senate Majority Leader Bill Frist, M.D., made several
suggestions on ways to provide all Americans with lifelong,
affordable access to high-quality health care. Senator Frist
graduated from Harvard Medical School in 1978, and was a surgeon
before entering politics. One of the key aspects of his vision
is a system that is responsive primarily to individual
consumers, rather than to third-party payers. This concept is
known as consumer-driven health care.



Today most health care is paid for and controlled by third
parties such as the government, insurers, and employers.
Consumers rarely compare prices or quality of service when
shopping for health care - partly because this comparison is
usually very difficult or even impossible, and partly because
the price often just doesn't matter to the consumer, who is only
responsible for a moderate co-payment. Frist notes "a
consumer-driven system will empower all people - if they so
choose - to make decisions that will directly affect the most
fundamental and intimate aspects of their life - their own
health. This empowerment gives people a greater stake in and
more responsibility for, their own health care. Health care will
not improve in a sustained and substantial way until consumers
drive it."



A key aspect to enabling consumer-driven health care was the
creation of tax-free Health Savings Accounts (HSAs). This
legislation was part of the Medicare Modernization Act (Public
Law 108-173). "HSAs, coupled with affordable high deductible
insurance policies, give individual consumers more control over
their health care choices and hard earned dollars. HSAs give
people a greater stake in their own health care. The accounts
can move with employees from job to job and can be rolled over
year to year. HSAs should increase demand for greater
information and transparency."



What Senator Frist is suggesting is that people with
health insurance plans and HSAs have incentive to keep their
health costs low, since any money they save on health care
expenses stays in their Health Savings Account, and grows
tax-deferred, like an IRA. Thus there is also incentive for the
consumer to demand information about health care pricing. No
system has yet been devised in the history of mankind that does
more to increase quality and lower prices than a competitive
market system. As more and more consumers begin to own health
savings accounts, health care providers will be forced to
compete for their business by providing better quality service
and better prices.



The other factor in play is the financial motivation the
individual will have to stay healthy. The vast majority of
health care spending today is due to degenerative diseases such
as high blood pressure, diabetes, metabolic syndrome,
cardiovascular disease, and other modern ailments that are
primarily the result of lifestyle choices. The consumer who
wisely spends his HSA dollars on preventative care (which can be
done tax-free) and pays attention to diet and exercise could be
rewarded with a substantial amount of money in their Health
Savings Account by age 65.



Consumer-driven health care has the potential to be a powerful
force of change in the health care system. By instituting
competitive pressures, encouraging greater price transparency,
and rewarding consumers who are proactive about their health,
the growing adoption of Health Savings Accounts will help make
health care more affordable for everyone.



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