[secabeen]

> When most people speak of health care “prices,” they often have in mind point-of-service prices one pays when picking up a prescription, being hospitalized, having a baby, or seeing a doctor.

This reminds me of the infuriating pattern in some health care conversations when discussing consumer discounts and rebates for prescription drugs. The pharma company will say, "we give pricing relief to our customers, and ensure that no patient will pay more than $20 for a monthly supply!" That's all well and good, but it elides over the fact that the insurance company is still paying $1000+/month for their share of the prescription, and that money eventually comes out of the patient or the employers pocket, which means it eventually comes out of our pockets as their consumers.

> However, when economists refer to “health care prices,” they mean the overall payments for a service—not just what the patient pays to the provider in the form of a copay or deductible, but what the insurer pays to the provider on behalf of the patient...But the distinction between these two ways of thinking about prices leads me to the second problem with the emerging price consensus: the failure to consider what is baked into the payments that payers (whether public or private) make to providers.

Fundamentally, if we were able to reduce our spend as a percentage of GDP to that of the average OECD country, it would remove $1 Trillion in annual revenue from our health care system. The existing health care industry is going to fight that tooth and nail. That doesn't mean we shouldn't do it.