Reach Upward nails it again when he talks about Serving Medical Customers.
One of the primary rules of economics is that suppliers do their best to supply what buyers actually demand. Who are the real buyers of medical services? Not you. Unless you pay for everything yourself or have only catastrophic insurance, you are not the buyer. . . The real buyers — the real power entities in purchasing medical services —are the government (via Medicare) and insurance companies.
Since suppliers provide what buyers demand, let’s ask ourselves what the real buyers of medical services demand. Do they demand the best possible medical outcome for each patient? Nope. It’s not possible for them to do that. So they design systems that aspire to that lofty goal. These systems seek to demand proof that proper procedures are being followed and tightly control what procedures will be covered.
Of course, to administer these systems, the government and insurers spawn massive bureaucracies of paper pushers. Medical practitioners actually serve their buyers quite well, supplying the desired paperwork. They report procedures that will bring payment. . .
Electronic Health Records (EHRs) have been touted as a way to improve the medical system. But it turns out that EHRs do not improve actual medical outcomes. This is because they are only a more efficient way of pushing paper around through the bureaucracy.
Every time I read anything about our health care system I come to the same conclusion – the best kind of insurance we could have would be catastrophic insurance that has incentives built in to reward consumers who avail themselves of preventive care. With the current push in Utah to provide universal coverage we cannot emphasize this issue too much. If we want to make the system better we must attack at the actual systemic problems (the shifting of the buyer role from individuals to corporations and government entities) rather than simply trying to massage the current system to assuage some acute and visible symptoms of systemic problems (the cost of health care and insurance).