Market Based Medicine
Ezra Klein and Megan McArdle debate the likely cost savings of consumer-based health care, with the former arguing it would come from poor patients having to ignore the excellent advice of doctors out of inability to pay and the latter contending doctors would quit ordering so many unnecessary tests if people had to pay for them out of their own pocket.
Both are likely right so far as it goes. Certainly, doctors would be forced to be more cost-conscious in their care routines under a purely market driven system. (Although it’s unclear how much of the unnecessary testing Megan describes is a product of featherbedding vice malpractice suit CYA.) Even so, the cost savings wouldn’t be sufficient to make health care affordable for the least of us.
Regardless, the current system is anything but market based (few of us have much incentive to care what our health care costs beyond the monthly premiums and deductibles) and there’s zero public appetite for making it more so. The momentum has been steadily and inexorably in the other direction for decades now.