It's long been the case that the cost of medicine has been distorted by a couple of critical factors:
The first is the third-party payer system.
When you somehow compartmentalize in your mind that someone else is footing the bill, it's easy to lose track of what things cost...after all, it's not really your money (or is it?). When employees are surveyed, and asked whether they would like to get a raise in an amount greater than their healthcare premiums or have healthcare as a benefit, most choose the healthcare benefit. That's just stupid.
The second is an entitlement attitude, fostered by statist elements...people who think they can make better decisions, or that they are smarter and thus should be making the decisions for the common man.
Unions have successfully negotiated, and government has pandered to the idea that healthcare is a right, no matter what the cost. The problem, of course, is that the real cost is employment. If healthcare costs are driven too high, eventually, you become un-employable because of your benefit burden.
The Direct Pay model, otherwise known as "Concierge Medicine", is the closest thing to "free-market" medicine, and possibly the best option for the small business owner and his employees and their families. It holds the hope of driving down costs, driving up quality, placing the medical decision-making back in the hands of the doctor and patient where it should be.
My own informal case studies have shown that for a small or mid-sized business, combining direct pay medicine with high deductible insurance policies, a company reserve to meet unfunded deductibles, and a medical savings account, can reduce the healthcare benefit expense for these small businesses by half.
Direct pay physicians are highly tuned-in to their patients needs. As a group, their technology tends to be more advanced, and more "patient-centric". Medicine, after all, should be a "service-oriented" profession.
