I’ll discuss these goals in more detail in chapter 9, but now I must comment on their underlying focus on consumer control. Many people will tell you that the current medical system’s focus is already on the patient. But seeing people as patients rather than as consumers or customers is actually part of the problem. The word patient is derived from the Latin patiens meaning “one who endures,” a definition that could hardly be more appropriate for today’s medical consumers. Viewing people this way puts them into a subordinate role to providers—and to insurers, governments, and employers. Yes, the patient is the focus of the current system—and many of the proposed ones—but more like an animal in a zoo is the focus of spectators, patrons, handlers, veterinarians, administrators, and fundraisers. A captive panda may indeed be the point of all these resources, but it hardly has a say in how it is treated. Consumers are too often viewed in a similar paternalistic way by our health care system. It assumes that it knows better than they what they need, what they can have, and how much they have to pay. We need a health care system that provides the information and the clout that allows people to make their own choices about what they consume and from whom. They should not be dependent on the benevolent intentions of others.

Those are the goals I propose for health care reform. Now let’s see how we can create a workable consumer market to achieve them. I propose a concept I call the American Choice Health Plan. Its purpose is to engage regulated market forces to the maximum practicable extent as the most cost-effective means to funnel scarce health care resources to everyone who needs them. The following discussion provides a summary overview of American Choice, with chapters 9–12 going into considerably more detail.

The American Choice Health Plan