New Frontiers for Patient Power

The idea behind Health Savings Accounts (HSAs) is a simple one: Instead of giving all our health care dollars to a third party (employer, heath insurance company or the government), we can put some of those dollars in an account that we own and control. When spending from that account, we become fully empowered consumers in the medical marketplace—reaping the full benefits and bearing the full costs of every decision we make.

Even if people don’t have money set aside in a Health Savings Account, patients are paying for more and more of their own medical expenses. Half of employees who get their insurance at work have a deductible of $1,000 or more. The average silver plan deductible in the Obamacare exchanges is almost $4,000. In response to patients paying with their own money and making their own decisions, a supply-side revolution has already taken place:

• Walk-in clinics provide timely care at affordable and transparent prices—meeting best practice guidelines more often, on the average, than traditional primary care physicians.
• On-line prescriptions drug firms are competing on price with local pharmacies and they have a lower error rate.
• About 11 million people have access to telephone and email consultations—something that still isn’t covered by Medicare, Medicaid and most commercial insurers.
• Using an iPhone app, people on the East Coast and the West Coast can summon a doctor to their homes at nights and on weekends—one who usually arrives within 30 minutes and costs about $100. That way, patients avoid a $500 bill and several hours of waiting at a hospital emergency room.
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