There are several lessons we have learned from the CoViD-19 experience such as: the unreliability of predictive models; the danger of depending on foreign supply chains; over-reaction can be a deadly as under-reaction; and the need for better contingency planning.
There is one lesson we have not absorbed: to get timely, affordable care, Americans need the private sector, the free market, not the government-controlled health care.
When the CoViD crisis began, it was private companies, not government agencies, that quickly produced diagnostic tests, personal protective equipment, ventilators, and developed ideas for both curative medicines and vaccines.
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The U.S. has not had a free market in health care since the 1930s. There is a third-party decision maker, either government or insurance, that disconnects buyer (patient) from seller (physician, hospital, pharmaceutical company). The third party decides what consumer must buy and dictates the seller’s price.
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What would a truly free market look like in health care, with no third-party decision-maker disconnecting buyer from seller? Sellers compete for buyers’ business. Buyers choose products and services based on quality and price, and pay their own money. In 2018, the average American family expended $28,166 on health care, more than 80 percent to insurance companies. As most were healthy, they paid a third of their total income for… nothing. Imagine if they could put that money in an HSA and it could accumulate.
Insurance returns to its original function: protection against financial catastrophe. Americans could buy catastrophic insurance with very high deductible, say $10,000, making health insurance very inexpensive. Just like buying a car or legal services, people shop for medical care and pay at time of service from their family HSA up to $10,000.
By Deane Waldman, MD MBA