Sick to Debt: How Smarter Markets Lead to Better Care

An informed argument for reworking the broken market‑based U.S. healthcare system by making cost and quality more transparent
 
The United States has the most expensive healthcare system in the world. While policy makers have argued over who is at fault for this, the system has been quietly moving toward high‑deductible insurance plans that require patients to pay large amounts out of pocket before insurance kicks in. The idea behind this shift is that patients will become better consumers of healthcare when forced to pay for their medical expenses.
 
Laying bare the perils of the current situation, Peter A. Ubel—a physician and behavioral scientist—notes that even when patients have time to shop around, healthcare costs remain largely opaque, difficult to access, and hard to compare. Arguing for a middle path between a market‑based and a completely free system, Ubel envisions more transparent, smarter healthcare plans that tie the prices of treatments to the value they provide so that people can afford to receive the care they deserve.

Peter A. Ubel, M.D., is the Madge and Dennis T. McLawhorn University Professor of Business, Public Policy, and Medicine at Duke University.