John Goodman, PhD, President of the National Center for Policy Analysis talks about the new idea of consumer-directed health care.
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Could an event of this nature have been held 5 or 10 years ago? John Goodman: To be very hard to hold a conference like this 5 or 10 years ago. The consumer directed healthcare idea is very new idea. It's going very fast, but it started with a small group of people and now just keeps enlarging everyday. What is the one single thing that can happen on the Federal level to improve the quality, cost and access to healthcare? John Goodman: The most important thing that the government can do to control cost is to let the patient control more of the healthcare dollars. That means everybody ought to have a flexible savings account that wraps around any health insurance plan and ought to be easy to do it. The more dollars that are controlled by patients, the more that we're going to control healthcare cost. How do you motivate those people who don't want to have that control? John Goodman: Oh! People who want other people to control their cost for them should be entitled to do that. That's really why we had the HML form of health delivery. You are going to plan, other people make all the decisions for you. There were always be people who want to surrender control over the healthcare to others and that might not be a bad decision for them. But what's going to control cost in the marketplace is patients monitoring the money where it goes. What's your opinion on third-party payers? John Goodman: While the source of most of our problems is the fact that there is a third party who pays the bill. So when we see the doctor, we are not paying, someone else is paying. On average, every time we spend a dollar in the doctor's office, only ten cents is coming out of our own pocket. So the other 90 cents is paying for by an employer, a health insurance company or the government. And the problem then is that third party is trying to control the cost, and as a result of that, the doctor can select the insurance company or the employer to decide what to do. So you're the patient, you think that the doctor is your agent, but in fact, the doctor is being forced to be the agent of this third party payer bureaucracy. What are you hoping people will take away from this event? John Goodman: I think it is the way people going to get a greater insight and to the odd, the many many dimensions of consumer directed healthcare and how it's affecting all parts of the market, the doctors, the hospitals, the insurance companies, the employers, everywhere we see entrepreneurs showing us things that we didn't know could happen, and that's what happens in the entrepreneurial marketplace. Do you see a danger in putting more control into the hands of the customer? John Goodman: Well, when people are controlling their own money, making their own decisions, they were sometimes make bad decision. There is no question about that, but you have to remember that nobody cares about you more than you will care about you. And so if you retain control over the money, you have the power to make decision. At the end of the day, the system is probably going to work better for you, than if you give up that power to somebody else.