What Emerging Markets Tell Us about Healthcare Reform

In fields as diverse as cosmetic surgery and LASIK surgery, we are discovering that healthcare markets can give patients transparent package prices and that costs can be controlled—despite a huge increase in demand and enormous technological change (of the type we are told increases costs for healthcare generally). For services as diverse as walk-in clinics and mail-order drugs, we are seeing that price competition is possible and that price competition promotes quality competition as well. In the international market for medical tourism, we are discovering that almost every type of elective surgery can be subjected to the discipline of the marketplace; that discipline is increasingly evident within our borders in the emerging market for domestic medical tourism, where patients willing to travel to other cities can find cheaper, higher-quality care.

In each of these cases, new products and new services have cropped up to meet the needs of patients spending their own money. These are products and services that were made possible precisely because the third-party-payer bureaucracies were not standing in the way. If the private sector is left free to continue with such innovations, there is much more to come.

Among the current buzzwords in Washington policy circles are such terms as electronic medical records, medical homes, coordinated care, integrated care, and so on. To hear the policy wonks tell it, the Affordable Care Act is designed to bring all these new ideas to the practice of medicine—prodded by the guiding hand of government regulators.

But did you know that sensible, workable electronic records systems (including the ability to electronically prescribe drugs) have been in use for over a decade by walk-in clinics, by private telephone and email consultation services, and by concierge doctors (who give their patients more time, more services, and special attention) without any guidance from Washington or from any employer or insurance company? Did you know that sensible, workable medical homes—together with diverse doctors providing integrated, coordinated, low-cost, high-quality care—have been emerging in the private sector for some time, without any federally funded pilot program or any advice, encouragement, or harassment from any third-party payer?

I stress the words sensible and workable because in the hands of impersonal bureaucracies, shielded from marketplace competition and subject to pressures from every special interest group imaginable, we are likely to get systems that are neither sensible nor workable.

Liberated from the confinement of legal impediments and suffocating bureaucracies, doctors, patients, hospital personnel and profit-seeking entrepreneurs are perfectly capable of solving our most serious health policy problems. All they need is the freedom to be able to do so.

For more, please see my Independent Institute book, Priceless: Curing the Healthcare Crisis.

[Cross-posted at Psychology Today]