Healthcare Costs Part 1

By Richard P. Holm MD

Maybe it was ten years ago I heard a political reformer pose the question: What if we paid for groceries like we pay for health care in the U.S.& how different would it be? He described buying groceries where there would be no reason to look for a bargain, but rather motivation to buy the most expensive items, and everybodys basket would be filled to the brim.

I think there is still some truth to the comparison, because in this world of third party payers for health care, the consumer is still not driven to look for value. Rather it seems the employer who buys the insurance has to do that. But in 2008 there are some changes we would have to make to the grocery-store/health-care comparison.

Now you find that there are only three grocery stores in the state, and you have to go to the store your employer chose. Upon arrival to the store you find a very elaborately decorated and expensive building, the carts are robotic, the aisles are wide and beautiful, and there are way more managers than checkout people, due to government beaurocracy.

Looking around you realize that every customer in the store seems to have a different way of paying for the food. One person has a plan where all the food is free, once he reaches his deductible, but it pays only for certain food, and he cant figure out what that is, except to know that generic beans are always paid for. And then there are customers who have managed care advisers walking around the store with them pointing out which food is not available to them. What's more, there are many people outside the store that can't get in.

It is not a perfect metaphor but it makes one point very clear the system is a mess. In this age of healthcare reform, please be pro-active and contact your Washington legislators.