replacing your tires regularly can save your life; similarly, getting regular check-ups can prevent major disasters and keep costs at every level contained — when the first time a doctor sees a diabetic is to amputate his feet, nobody wins (not least the system paying for a lifetime of nursing care he wouldn’t have needed with regular oversight of his disease).

beyond that, penny-pinching can be a disaster in unforeseen ways; we in Pennsylavnia saw a kid of 5 or 6 die a few years back from an infected tooth (which became a full-body sepsis) when his mother had to delay his dental care due to other pressing monetary needs. similarly, the vast majority of prenatal screening does nothing, but for the 5% of mothers with problems, it saves millions in emergency care, high-risk deliveries, and damaged children. there are just lots of ways that regular check-ups are more than a convenience. I wish folks making arguments like yours would look at the actual data.

Why care that one prescription drugs costs $120 at this pharmacy, while a different drugs costs $80 at a different pharmacy? You pay your $30 tier II copay or whatever and go along your merry way.

Or how about one of the biggest scams, your primary care copay is $30 regardless of whether you see a NP, PA or MD. Of course, the insurance company gets billed the exact same thing.

Does it matter if you go to this doctor over here for an outpatient surgery or that one on the other side of town? The costs could be hundreds of dollars in difference. We’ll drive all over the place to save $2 on a gallon of milk, and yet we shouldn’t care what our health care is costing?

I’m mainly talking about routine care and prescription drugs. Obviously, emergency care and life saving care is fairly price insensitive. Then again, I don’t insure my car against oil changes and new tires, I don’t know why we have health insurance for anything other than emergency care/surgery.

Come on, now. Healthcare is a service, but it’s hardly the same kind of service as a freakin’ day spa and the same kinds of cost sensitivity simply don’t apply. As it is now, it’s the doctors who are incentivized to offer more or higher-cost options, anyway, as opposed to the best care. Not to mention that preventative options are in nobody’s interest but the patient’s.

I think the issue that is too often overlooked is the one in Rafe’s last paragraph. We are less free as individuals because of the current structure of the healthcare system. It is a heavy drag on innovation, entrepreneurialism, and mobility for individuals and families, and on the economy as a whole.

Let’s not forget how strictly the government controls the supply of health care in this country. For example, in NC the state controls the number of seats in each medical school, the number of doctors licensed, the number of hospital beds, the number of CAT and MRI scanners, etc. When you limit supply, without changing demand, prices will usually increase.

I really wish this side of the story were getting discussed at all. I agree something needs to be done, but I don’t understand why we everyone is ignoring the dynamic we have today in which if you have insurance you don’t care about the cost of the care you receive?

With that experience, I shudder thinking about going through the system without any insurance and being at the mercy of what the hospital, physician and equipment technicians charge. It significantly affects my own entreprenureal calculus.