Transforming Our Health Sector By Empowering Consumers

By Grace-Marie Turner

The health sector is poised to enter a dramatic new era of consumer-driven health care. People are demanding more control over decisions involving their health care and medical coverage. And the Internet allows consumers easy access to a wealth of medical information that was available only to professionals as recently as a few years ago.

But public policy is lagging behind. It is suited to an Industrial Age, not our Information Age. Private and public sector bureaucracies, not consumers, still are in charge because they control the finances and therefore the decisions.

The United States has been struggling for decades to find a way to provide its citizens with access to health insurance. We have expanded existing government health care programs, especially Medicaid, to cover more and more people and have even created new programs, like the State Children’s Health Insurance Program.

Yet the number of uninsured remains stubbornly high. It seems clear that we need to look for other solutions. And that means looking not at further expanding government programs but at harnessing the creativity and energy of the private sector. As amazing as it may seem in our capitalistic economy, this is the one thing we haven’t tried!

And the public policy change that will empower millions of consumers to lead this transformative change is giving them more financial control over their health care and health coverage.

President Bush has proposed providing refundable tax credits to the uninsured to help them purchase health insurance. To make the distribution of the subsidies even more direct, new “health certificates” also could be offered to help individuals and families purchase private health insurance. If these new financing mechanisms are enacted, they will enable a newly-empowered army of consumers to shop for the health policies that best suit their personal needs. They will force the insurance industry and the medical profession to cater to them, not to a distant bureaucracy.

Widespread individual ownership of health insurance would be a fundamental and positive change in our health system, and refundable tax credits and health certificates are the tools to make that happen.

We are at a crossroads. Right now, nearly one out of every two dollars spent on health care in this country comes from government. Without dramatic change, we could easily topple in the direction of a government-controlled health system.

The alternative is to lead the way to a revolutionary new system that gives people choice and control over their health coverage. A consumer-driven health system would provide incentives for innovations in health care financing and care delivery. Empowering consumers with new resources will lead to bold, dramatic changes in our health care system that will be transformative in solving many of the problems with cost and access that plague our system today.


Grace-Marie Turner is president of the Galen Institute, a free-market public policy research organization founded in 1995 to promote education on health and tax policy issues. The Georgia Public Policy Foundation, an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the views of the Georgia Public Policy Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.

© Georgia Public Policy Foundation (November 7, 2003). Permission to reprint in whole or in part is hereby granted, provided the author and her affiliations are cited.

By Grace-Marie Turner

The health sector is poised to enter a dramatic new era of consumer-driven health care. People are demanding more control over decisions involving their health care and medical coverage. And the Internet allows consumers easy access to a wealth of medical information that was available only to professionals as recently as a few years ago.

But public policy is lagging behind. It is suited to an Industrial Age, not our Information Age. Private and public sector bureaucracies, not consumers, still are in charge because they control the finances and therefore the decisions.

The United States has been struggling for decades to find a way to provide its citizens with access to health insurance. We have expanded existing government health care programs, especially Medicaid, to cover more and more people and have even created new programs, like the State Children’s Health Insurance Program.

Yet the number of uninsured remains stubbornly high. It seems clear that we need to look for other solutions. And that means looking not at further expanding government programs but at harnessing the creativity and energy of the private sector. As amazing as it may seem in our capitalistic economy, this is the one thing we haven’t tried!

And the public policy change that will empower millions of consumers to lead this transformative change is giving them more financial control over their health care and health coverage.

President Bush has proposed providing refundable tax credits to the uninsured to help them purchase health insurance. To make the distribution of the subsidies even more direct, new “health certificates” also could be offered to help individuals and families purchase private health insurance. If these new financing mechanisms are enacted, they will enable a newly-empowered army of consumers to shop for the health policies that best suit their personal needs. They will force the insurance industry and the medical profession to cater to them, not to a distant bureaucracy.

Widespread individual ownership of health insurance would be a fundamental and positive change in our health system, and refundable tax credits and health certificates are the tools to make that happen.

We are at a crossroads. Right now, nearly one out of every two dollars spent on health care in this country comes from government. Without dramatic change, we could easily topple in the direction of a government-controlled health system.

The alternative is to lead the way to a revolutionary new system that gives people choice and control over their health coverage. A consumer-driven health system would provide incentives for innovations in health care financing and care delivery. Empowering consumers with new resources will lead to bold, dramatic changes in our health care system that will be transformative in solving many of the problems with cost and access that plague our system today.


Grace-Marie Turner is president of the Galen Institute, a free-market public policy research organization founded in 1995 to promote education on health and tax policy issues. The Georgia Public Policy Foundation, an independent think tank that proposes practical, market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the views of the Georgia Public Policy Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.

© Georgia Public Policy Foundation (November 7, 2003). Permission to reprint in whole or in part is hereby granted, provided the author and her affiliations are cited.

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