Healthcare Costs Must Be Controlled by Patients

The debate on healthcare reform today revolves on how they could fix the waste in hospitals, doctor delivery, etc. But there is evidence to suggest that nothing is going to get fixed till the people who are requesting healthcare, the patients, have a direct stake in how much costs. The very best evidence of this I heard was from Steve Forbes (wouldn’t you know). Now I do not agree with Steve Forbes all the time but this is simply an observation he made. There are at least 2 healthcare areas where people have to pay as they go and shop by price and value.  One of the areas is plastic surgery and one is Lasik. I did the research on Plastic Surgery and low and behold the average procedure had an inflation rate between 2001 and 2007 is around 2%. That’s right 2% during a period where standard healthcare costs are rising annually over 10%.  I’ll bet you will find the same low inflation rate in Lasik.  Why are these two areas cost controlled so well? The main difference from your family physician is that the patient has to pay directly for these two procedures out of their own pocket.  Because of this people vote every day with their dollars for better outcomes with less cost. And MOST of the outcomes of the 1000′s of procedures done every day are just what the patient wanted.

There is a second significant difference between those to areas of medicine and the mainstream illness areas, those two items are fully discretionary.  You don’t have to have them to survive.  It is for that reason that we have the desire to fund healthcare for everyone.  It is also for that reason that I am not advocating we should go to a fully personal pay healthcare system.  What I am advocating, from the evidence, is somehow creating an individual stake in the cost.  Patients need to CARE how much it costs when they select a Doctor, Hospital or procedure and make good value decisions on that basis.  Patients can be trusted to make good decisions most of the time. And the collective intelligence of our entire country will then be turned to fixing the problems because everyone needs healthcare and every time they need it they will be focused on getting the most efficient and effective care.

Here is the evidence:

From I got the average 2002 costs.

From for the 2007 costs.

I selected just a few of the very frequently used procedures, reported are the Doctors cost.  There are far more of all of the procedures done in 2007 than in 2002. One of the issues reported as a cause of the tremendous healthcare cost rise is much more demand stressing hospitals and doctors. Well, there’s lot’s more demand here and the average inflation of these procedures appears to be just about what the average national inflation rate has been.

2002 Eyelid Surgery was $2,455 average cost and in 2007 it was $3,134, an annual inflation of 4.6%.

2002 Breast Augmentation was $3,436 and in 2007 it was $3,816, a mere 1.8% inflation rate.

Botox in 2002, $422 in 2007, $501 an annual increase of 3.1%.

Breast Implant Removal, $2,084 vs. $2,380 for 2.4%.

Finally a Face Lift actually showed a negative 1% inflation, 2007 cost was more than 6% less than 2002.

Again I’m not saying that we should completely go to a no insurance pay as you go but I am saying that if we all had a stake in the cost of our healthcare we would vote EVERY DAY for better outcomes and less money and low and behold we would get it.