Competition in Health Care
Both Health Insurance and Provider Markets Need to Function Competitively

Health care is on a collision course with patient needs and economic reality. In today's dysfunctional health care competition, players strive not to create value for patients but to capture more revenue, shift costs, and restrict services. To reform health care, we must reform the nature of competition itself. Redefining Health Care provides an overall framework for diagnosing and solving this immense problem, with detailed action steps for all participants in the health care system.

As in other markets, the goal for health care markets should be to ensure that consumers benefit from a competitive marketplace where neither the buyers nor sellers unlawfully exercise market power. Policy should focus on ensuring that there is a competitive marketplace where neither health insurance plans nor health care professionals are able to obtain or exercise market power to distort the competitive outcome. Any other result inevitably will lead to governmental regulation of the health care market -- an outcome that is not likely to produce desirable results for consumers. We have learned this lesson over time from other industries and we should be sure we continue to apply it to health care markets as well. The injection of competition into quality health care markets over the past decade should have helped hold down increases in health care costs. But not enough.

1.     Consumers/patients should get the cost of services, prior to providing any healthcare services.

2.     Consumers/patients should not be forced due to emergency medical condition pay exorbitant fees and costs. (No price gouging)

3.     Consumers/patients should have a government agency where they can complain when charges are exorbitant and way above the cost of the competition.

4.     Just because the Health Insurance Company pays the bill, it is not permitted for the healthcare service provider to bill exorbitant billing, The consumer/patient pay a percentage of the services, therefore price and costs are important, not to mention that if healthcare costs and billing to the Healthcare Insurance is exorbitant, this will increase the costs of health insurance to the employer and employee.

5.     Uninsured/consumers/patients should not have to pay higher prices for healthcare services than insured consumers/patients.

6.     How do you treat a healthcare provider who were found to abuse and charge exorbitant prices for its service, were fined by the government and now continues to charge exorbitant charges for its services? The penalty should be that the consumer/patient bill should be nullified. (plus other appropriate penalties).

7.     Any provider found to be over-billing, inflating billing, gouging prices and billing, or billing for services not rendered – should have severe civil and criminal penalties.

8.     Much more to come (can you justify $1000 for insulin shot)

By: Miriam Draiman,

Real competition is the cure for health care

Health care costs are climbing, quality is spotty, and patients don't get the information they need to evaluate either. No one seems to have the solution.

That is why we need market competition more than ever. Not the mealy-mouthed substitutes bandied about by most health policy wonks. We need something that none of us has ever seen - real competition in a free health care market.

We need it because competition is a tool for finding solutions. "Competition must be seen as a process in which people acquire and communicate knowledge," including innovative ideas for improving quality and reducing costs. In a free and open market, economic competition casts a wide net for the best ideas and puts them to work.

Where real market competition can be found in health care, it drives quality upward and prices downward.