Most patients don’t pay for health care at the time of its purchase. Today only 15 percent of per-capita health-care spending is out of pocket. After the initial insurance premium has been paid, actual services require only a token co-payment. This nominal fee does not reflect the actual cost of the service. Patients pay an artificially depressed cost, which leads to increased demand and soaring health-care costs. Most Americans are simply unaware of and unconcerned about costs when purchasing health-care services. Those costs are perceived as someone else’s expense. But of course, patients ultimately do encounter the increased costs in the form of rising insurance premiums or lost wages.Agreed. See also Nick Gillespie at Reason:
[T]he system, including the vague reforms being championed by Barack Obama in a speech designed to lay out his plan in detail, really don't do anything to empower the person at the center of the drama--the patient, the customer--with the sort of choices that might actually trigger changes that will either curtail costs or, same thing, improve the range and quality of services so that we are happy with the money we're shoveling out.
Until that discussion gets underway, any so-called reform will fail to deliver on anything other than empty promises.