The real key to Patient Protection and Affordable Care (Acting)

Every health care service that patients pay for out of pocket has falling real prices.  Every health care service that insurance pays for has rising real prices.  Knowing that fact what would you do to protect patients and help make care more affordable?  In other words if you were the "Lightbringer" seeking to "fundamentally transform" America (at least in a way that makes more Americans happy), how would you PPACA?

Here is general healthcare price inflation relative to the Consumer Price Index (incidentally, I believe this includes the falling price sectors that are not insured so the insured sector price inflation is probably somewhat higher). It's not a pretty picture.

Contrast that with what has happened to the price of cosmetic surgery which customers pay for out of pocket with their very own money earned by their own widdle hands:

So it turns out the venal, self serving purveyors of tummy tucks, boob jobs and Nancy Pelosi's fright mask are actually less thieving than the selfless servant surgeons and physicians who care so deeply doing 'real' medicine..  Boy I wish we could get the humanitarians to care a little bit less and compete a little more on price, don't you?

But this is just one sector.  It's not real medicine.  OK, lets take a look at laser eye correction surgery, known as Lasik.  Lasik is not paid for by most insurance plans, yet once again its prices have fallen relative to the general price level.  It seems that evil capitalists have gotten a hold of the sector and applied their black magic to it.  Foul spells like:  scale economies, experience curves, specialization, automation, discounting, price discrimination and (gasp!) the profit motive.  The result:  a lot fewer lasik practitioners with much higher productivity and velvet for their patients.  You know it was just this sort of vile capitalist behavior that Barack Obama was elected to stop!

You'll note that average pricing includes a major technological innovation that improved quality and safety yet at the end of the day, average prices remained the same in nominal terms even with the better procedure factored in.  Suffice it to say that other ophthalmologic procedures paid for by third parties saw their nominal prices soar.  Presumably because they were "doing it for the children", God bless 'em.  Here's a good summary of the above.

So eyes, skin, boobs, 'big deal', how about something really important like hearing?  The hearing aid market is largely a senior citizen market and Medicare does not cover it.  Historically hearing aids have been custom fitted by audiologists and cost $3,000 the pair with lush margins for both the audiologist and the hearing aid manufacturers.  Today with the advent of smart phones perfectly functional hearing aid apps are selling for $3.99 and can be linked with any manner of inexpensive in ear speakers.  See here.

Imagine how much they would cost if the 'lightbringers' had organized a 'socially responsible' 'Universal Hearing Program'?

At some point the politicos need to recognize that they have no idea how to manage supply, demand and pricing for health care services (or any other damn thing for that matter) and instead allow as much as is humanly possible a true market to function where only truly catastrophic health care events are covered by insurance.  It's only when consumers can make valid trade offs between all of their consumption options and pay for their choices with their money that disciplined markets that optimize cost, quality and innovation exist.  Of course to do this would require the Obami to repudiate almost all of their 'reform' and reimplement and extend the W. Bush insurance reforms that they just superseded.

And given the absolute swingeing chaos that Obamacare has become we might get what we need done simply because the insurance market collapses.