You might want to read Scott Atlas’s thoughts on genuinely affordable health care at Defining Ideas. He proposes three different sets of changes:
- Incentivize and equip consumers to consider price.
- Strategically increase the supply of medical care to stimulate competition.
- Introduce the right incentives into the tax code.
While I think he’s on the right general track, I’m afraid that even if fully adopted those measures would prove inadequate. Basically, the evidence that people make prudent choices about health care, regardless of incentives is weak. They economize in ways that increase long term costs and fail to economize when it would make sense. They assume that increased care can make up for reckless behavior.
You can have fee for services or you can have physicians determining the course of treatment. The sad reality is that if you have both, there’s no practical way to control costs while preserving reasonable levels of public health.
Let’s define our terms. I think that health care should be deemed unaffordable in any system in which spending on health care rises faster than spending outside of health care. Who pays is less important than how much.
Most of the argument over the last decade has been over who pays. IMO that’s misdirection, sleight of hand.