Patient power

In today's bureaucratic health care system, the patient's major role is to sign the forms that authorize one large, impersonal organization to release funds to another, argue John Goodman and Gerald Musgrave. Government, through Medicare and Medicaid, buys close to half the health care provided in America today. Most of the other half is paid for by insurance companies, because the tax laws encourage people to rely on first-dollar health coverage from their employers. When health care appears to be free or very cheap, people buy more than they would if they were paying the full cost. The resulting casual attitude toward shopping for health care drives up prices, which drives up insurance premiums, which creates hardship for business and those without insurance. That spiral eventually harms all users of health care. The Goodman and Musgrave solution is to restore power and responsibility to individual consumers. If individuals are allowed to deduct the cost of their own insurance, they will have a stake in finding the best insurance value. Most consumers will discover that high-deductible insurance is a far better buy than low-deductible policies because the cost of handling small c