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Authors: Matt Kibbe
Tags: Politics
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“wavefront-guided” techniques have significantly improved the speed, reliability, and comfort of the procedure for patients. That record of increasing value compares extremely favorably with other areas of health care that are typically covered by insurance. In areas dominated by third-party payment, it’s not the value that goes steadily up, year after year, but the cost.
The paternalist types will protest: well, maybe economic freedom works for optional services like cosmetic surgery, but surely we can’t trust people to be in the driver’s seat for their own care when it comes to serious ailments like cancer and heart disease! Actually, we can. It’s true most of us have never been to medical school. But when it comes to making health care decisions for ourselves, there’s no reason why we can’t make prudent choices with the help of our doctors, without interference by third parties.
When you walk into a typical modern grocery store, what do you see? An incredible, almost bewildering array of products. How did that remarkable cornucopia come into existence? Who decided how much shelf space to devote to tomato soup, as opposed to candy bars? Why does one brand get more space than another? Why are some products not offered at all? Who planned all this?
The answer, of course, is no one planned it. The miracle of the grocery store is generated out of the trillions of small decisions made by millions of individual shoppers every day. These choices are constantly shaping and refining what you find when you walk into Safeway or Wal-Mart. We aren’t all farmers or chefs, and most people don’t even pay that much attention to what groceries they buy. But driving up the quality of choices doesn’t require everyone to be an expert, nor does it take every single shopper scrutinizing every product carefully. Even if just a small handful of smart shoppers make careful discriminations between products, favoring those of highest value and eschewing those of lower value, the effect is sufficient to be transformative. These informed consumers’ choices signal to the grocer: stock more of this, less of that; provide more shelf space for this, less for that. It’s awesome. Especially for us lazy shoppers, who get to glide along in the wake of our neighbors who are more aggressive discriminators of price, quantity, and quality.
FOOD FOR THOUGHT
W HAT’S TRUE OF GROCERY STORES CAN ALSO BE TRUE OF HEALTH care. In fact, as it happens, one great example of health care innovation based on putting patients first can be found at Whole Foods Market. The chain’s cofounder and CEO John Mackey has empowered “team members” at Whole Foods to voluntarily choose high-deductible insurance plans coupled with Health Savings Accounts. The result has been better choices at lower costs. According to Mackey,
The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction. 32
John Mackey is an interesting cultural mash-up, best understood by imagining what might have happened if Ayn Rand and Jerry Garcia had procreated. Mackey would surely be their love child—half organic-food-obsessed,
The paternalist types will protest: well, maybe economic freedom works for optional services like cosmetic surgery, but surely we can’t trust people to be in the driver’s seat for their own care when it comes to serious ailments like cancer and heart disease! Actually, we can. It’s true most of us have never been to medical school. But when it comes to making health care decisions for ourselves, there’s no reason why we can’t make prudent choices with the help of our doctors, without interference by third parties.
When you walk into a typical modern grocery store, what do you see? An incredible, almost bewildering array of products. How did that remarkable cornucopia come into existence? Who decided how much shelf space to devote to tomato soup, as opposed to candy bars? Why does one brand get more space than another? Why are some products not offered at all? Who planned all this?
The answer, of course, is no one planned it. The miracle of the grocery store is generated out of the trillions of small decisions made by millions of individual shoppers every day. These choices are constantly shaping and refining what you find when you walk into Safeway or Wal-Mart. We aren’t all farmers or chefs, and most people don’t even pay that much attention to what groceries they buy. But driving up the quality of choices doesn’t require everyone to be an expert, nor does it take every single shopper scrutinizing every product carefully. Even if just a small handful of smart shoppers make careful discriminations between products, favoring those of highest value and eschewing those of lower value, the effect is sufficient to be transformative. These informed consumers’ choices signal to the grocer: stock more of this, less of that; provide more shelf space for this, less for that. It’s awesome. Especially for us lazy shoppers, who get to glide along in the wake of our neighbors who are more aggressive discriminators of price, quantity, and quality.
FOOD FOR THOUGHT
W HAT’S TRUE OF GROCERY STORES CAN ALSO BE TRUE OF HEALTH care. In fact, as it happens, one great example of health care innovation based on putting patients first can be found at Whole Foods Market. The chain’s cofounder and CEO John Mackey has empowered “team members” at Whole Foods to voluntarily choose high-deductible insurance plans coupled with Health Savings Accounts. The result has been better choices at lower costs. According to Mackey,
The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction. 32
John Mackey is an interesting cultural mash-up, best understood by imagining what might have happened if Ayn Rand and Jerry Garcia had procreated. Mackey would surely be their love child—half organic-food-obsessed,
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