This model already exists in other forms in the US. One of them is called a healthshare. Usually a religion-based scheme where you pay in a certain amount a month, and then you negotiate with the doctor yourself, pay the bill yourself, and then get reimbursed by the healthshare if there is enough pooled money.
This does a number of things:
1) It puts patient skin-in-the-game in that they have the direct incentive to shop around and/or negotiate lower bills since they have to front the cost.
2) it removes the costly middle-men referenced in this article and all the administrative cost that goes with that.
3) It puts much more of the administrative burden on the patient because they have to negotiate and pay, keep track of things, then get reimbursed.
These three things result in reduced monetary costs, but add other costs like the patient's time and stress level.
Healthshares previously could only exist if they had been grandfathered in via a special provision in the ACA. Since then enough of the ACA has been eaten away that new healthshares are taking advantage of the resulting loopholes.
This does a number of things:
1) It puts patient skin-in-the-game in that they have the direct incentive to shop around and/or negotiate lower bills since they have to front the cost.
2) it removes the costly middle-men referenced in this article and all the administrative cost that goes with that.
3) It puts much more of the administrative burden on the patient because they have to negotiate and pay, keep track of things, then get reimbursed.
These three things result in reduced monetary costs, but add other costs like the patient's time and stress level.
Healthshares previously could only exist if they had been grandfathered in via a special provision in the ACA. Since then enough of the ACA has been eaten away that new healthshares are taking advantage of the resulting loopholes.