The New England Journal of Medicine
January 20, 2005
Health Care in the 21st Century
By William H. Frist, M.D.
Consumer-Driven Health Care
The new system also must be responsive primarily to individual consumers, rather than to third-party payers. Most health care today is paid for and controlled by third parties, such as the government, insurers, and employers. A consumer-driven system will empower all people – if they so choose – to make decisions that will directly affect the most fundamental and intimate aspect 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.
Affordable Health Coverage for All Americans
Tax-free health savings accounts (HSAs), adopted in 2003 as part of the Medicare Modernization Act (Public Law 108-173), will help speed the movement to a more consumer-driven health care market. It is estimated that half of all employers will offer HSAs to their employees within the next two to five years. 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.
Conclusions
American health care is at a crossroads. Rapidly advancing forms of technology are dramatically improving lives. Simultaneously, U.S. citizens face enormous inefficiencies, escalating costs, uneven quality, disparities in health care, and rising numbers of uninsured people. For decades, policymakers have debated and rejected a variety of solutions. What we have never done in the health care economy, however, is foster the kind of competition that has made other industries the most successful, prosperous, and advanced in the world.
http://content.nejm.org/cgi/content/full/352/3/267
Comment: Sen. Frist uses rhetoric that makes every free market enthusiast’s heart pound with sheer joy. But those who understand the current policies that have resulted in our extravagantly expensive but perilously underperforming health care system, also understand the policies behind Sen. Frist’s rhetoric. Not only is he implicitly supporting financial hardship and personal bankruptcy, but, worse, he is supporting policies that can only increase suffering and death.
Tragically, Dr. Frist is allowing political ideology to trump beneficial health policy. It is difficult to reconcile this with his role as a colleague in the healing arts.
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