Value is not in the vocabulary of health care.
When the President talks about markets in health care he seems to mean that price. features and ultimately the value to the individual should determine purchases. That’s not a bad idea when buying a car, television or almost any consumer item. In those areas the item is discretionary and the purchaser does not perceive his/her life to be at risk. There are multiple virtually equivalent options. Pricing is more or less standardized–we all start from the same sticker price. The special features of each option are generic and apply to all those who purchase the item. Time is not critical to the decision process. Finally, understandable information regarding the benefits of each option is available, some from impartial sources.
In health care the consumer believes his/her well-being, ability to live without disability, and even life may be at stake when purchasing services or products. Options may be severely limited. Pricing and quality information (outcomes) is not easily available or understandable. Each patient’s case has variables that make the situation specific to the case and not generic. Hospitals seemingly charge each customer differently with as much as a 100% markup for an individual payer. Time is a factor and delay often unacceptable–delay may mean death. Finally, in most instances a consumer would have difficulty making a rational choice without guidance from his/her professional–who may be biased.