This is not a pro Giuliani blurb. But Giuliani did point out one aspect of the "solution" to the health care crisis that is being ignored by others: Specifically, that the COSTS of medical care in terms of prices charged for such care must be part of any "solution."
Like anything else that we have blind spots about, we are refusing to pay attention to this aspect of the problem. It is ridiculous to think that health insurance costs can be cut without cutting coverage unless the prices charged for health care are also reigned in.
With the unpopularity of the HMO, we are also ignoring its strongest benefit: The power of a group of people participating in a contract was leverage in negotiating costs. Now with everyone being "empowered" to do better themselves, this leverage is gone.
Any reduction in health insurance costs has to come from cuts and new company "efficiencies" in order to provide insureds with cheaper insurance. That's a no brainer. But the cost of obtaining medical care should not be an immovable piece of the problem. It's movable, in spite of those nostalgic customers who want to believe in the homey doctor doing what's best for the community and getting paid in chickens, it's time to wake up and smell the coffee. Doctors and medical care providers are doing fine. Consumers have to figure out a new way to regain the edge in negotiating for the cost of care with medical care providers.
Task a day insurance: Right now, the best way to shop price is to consider using cost calculators. With a click of a mouse button on many insurer websites, consumers can see how much of a provider's fees are covered and the usual and customary, or going rate for the service in their area. If your provider is at the high end of the spectrum, find out why. You don't need the highest price optometrist to get glasses, or the highest priced internist to get a physical.
Without controlling the cost of the services we are buying, a cheaper price is based on providing less. If you don't believe me, consider the supplemental insurance market, more picayune by the year as we pay for additional policies to cover each hole left by the prior policy. Addressing the cost of medical care should be at least as important as controlling what people eat and drink in order to reduce the cost of health care.
Myth: Prevention does not control the cost of health care it AVOIDS the cost of health care. It is when prevention fails, or bodies fail, or circumstances fail and we are ill that we need health care.
