In 1960, 50 percent of personal health-care spending was paid for by patients out of pocket. Today, that figure is about 10 percent. We will never again see a patient-centered system as long as someone else is paying the bills.
I was responding to an op-ed by someone claiming that the reason that today's doctors are more beholden to insurance companies is because the doctors are greedier. Before they would print the letter, the Post called me and asked for sources for my figures. I had forgotten where I had seen the 50 percent figure. The more recent 10 percent figure comes from the Cato book Healthy Competition, by Michael Cannon and Michael Tanner.
Fortunately, I was able to Google my way to this book, which has it. It also points out that for the narrower category of physicians' services, out-of-pocket payments accounted for 62 percent of spending in 1960. It seems almost almost foreign to be paying that much of your own medical bills. Kind of like listening to music by playing 45's.
Health care cost inflation was not a concern in 1960. Certainly, having consumers pay for most of their health care spending out of their own pocket would have a major impact on costs. Routine health care could be as cheap as any other service we pay for, like a night at McDonald's or Applebee's.
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I agree. If we paid I believe costs would be down and people would be less likely to head to the doctor or ER for a runny nose. My mom and dad would testify on behalf of self-paying. They did it years and years ago with no problems. And they can give you examples almost to the year of when costs started going up and they all coincide with insurance becoming the behemoth it now is.
And, as another angle, a friend is an OBGYN. He cannot work out lower payments for cash payments because if he does the insurance companies will cut his reimbursement rate to match what he charged the cash customer. His overhead is mostly due to office people doing insurance billing...and his own liability insurance.
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