Given the nature of healthcare and health insurance, it's possible to have patients make some economic decisions, but certain things interfere with this. First of all, if someone goes to a doctor, then the doctor usually has more input to which services will be demanded than the patient does. The doctors let the patient know which tests and procedures should be chosen although good doctors give patients alternatives. Conversely, if someone walks into a grocery store, then the grocer does not decide which things a customer should purchase. Second, insurance covers most healthcare costs so any co-pays and deductibles will have an impact, but it will be limited. Well managed insurance companies are careful in how they set-up cost sharing. For example, they will not have cost-sharing for screening colonoscopies because these procedures save money by catching problems upfront. Similarly, patients are much better off if they take anti-hypertensive medication, and doing so also saves a ton of money, so well managed insurance companies do not charge co-pays on these medications. Some insurance companies also provide incentives to doctors who avoid medical errors because many of these errors can lead to bad patient outcomes and high additional costs. I could give many other examples. There are many problems, but thought is often given to economic incentives that improve quality for patients and save money.
Given the nature of healthcare and health insurance, it's possible to have patients make some economic decisions, but certain things interfere with this. First of all, if someone goes to a doctor, then the doctor usually has more input to which services will be demanded than the patient does. The doctors let the patient know which tests and procedures should be chosen although good doctors give patients alternatives. Conversely, if someone walks into a grocery store, then the grocer does not decide which things a customer should purchase. Second, insurance covers most healthcare costs so any co-pays and deductibles will have an impact, but it will be limited. Well managed insurance companies are careful in how they set-up cost sharing. For example, they will not have cost-sharing for screening colonoscopies because these procedures save money by catching problems upfront. Similarly, patients are much better off if they take anti-hypertensive medication, and doing so also saves a ton of money, so well managed insurance companies do not charge co-pays on these medications. Some insurance companies also provide incentives to doctors who avoid medical errors because many of these errors can lead to bad patient outcomes and high additional costs. I could give many other examples. There are many problems, but thought is often given to economic incentives that improve quality for patients and save money.