Healthcare services are the only service provided where no one knows what the service cost. The provider or hospital can’t tell the consumer what the service cost, the consumer has no way to find out what the service cost and the consumer must sign an agreement to pay for the cost if it is not covered by the insurance company.
USA is based on capitalist economies, individuals are free to make economic choices, such as what to buy, sell, or invest in, and wealth tends to be distributed based on market performance and individual contributions. Capitalism doesn’t
apply to healthcare.
The classic definition of capitalism is an economic system in which the means of production (such as factories, land, and resources) and distribution of goods and services are privately owned and operated for profit. The key features of capitalism include:
- Private Property: Individuals and companies have the right to own and control property and resources.
- Market Economy: Goods and services are exchanged in markets where prices are determined by supply and demand.
- Profit Motive: The primary goal of businesses and individuals is to maximize profit.
- Competition: There is competition between businesses, which encourages innovation, efficiency, and lower prices.
- Limited Government Intervention: While governments may regulate certain aspects of the economy, there is generally less interference in the market compared to other economic systems like socialism.
Capitalism element 2, 3, 4, and 5 don’t seem to apply to health care.
There are 8 states that have made attempts to make healthcare cost transparent.
We have federal programs to make healthcare data available but no federal policy to make healthcare cost transparent.
I have a deep understanding of why healthcare cost transparency is big challenge.
I also have a simple solution that could expose the healthcare cost and force the current healthcare market to compete in a capitalism based economic system.
We need a federal policy to require Providers, hospitals, insurance companies to publish CPT code. NDC Code , Revenue code, and DME code cost transparency.
I know how to operationalize the policy with low impact to the market participants. The approach would basically eliminate any excuses that would delay the implementation of the policy.
Pure Capitalism will course correct the healthcare cost trajectory.