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n the gap between excellence and perfection, there is suffering, harm, tragedy, and death."
-- Jim Conway

There is a growing consensus that our health care system is in a crisis. There have been increasing calls for health care reform. When compared to other industrialized nations the United States is falling behind, with a below average life expectancy and the most money spent per capita on health care.           

One answer is consumer driven health care.  The driving force behind consumer driven health care is the desire for consumers to shop for the highest value in medical care.  They have both a financial and personnel interest driving their quest to obtain the highest value. Op-Ed: Health Care in Crisis
Op-Ed: Medical Tourism

 Value = Cost + Quality

Before a consumer can shop for the highest value. The consumer will need to be able to compare the quality and cost of the product. There is a lack of "transparency" in the healthcare market for quality and cost of a service. This information can be very is hard for a perspective patient to come by.

Feb 2007: Dept. Health and Human Services' Secretary Mike Leavitt calls for support of the four "cornerstone" actions of the recent Presidential Executive Order calling for the – interoperable health IT; transparency of quality; transparency of price; and incentives for high-value health care:

A third factor is that of choices.  A consumer must be able to choose between providers before true competition in price and quality can occur. Without competition, markets with monopolies may endure both higher prices and lower, not increased quality.

Many States still have a certificate-of-need which is required to build a health care facility or to provide many health care services. The CON was initially mandated in the 1970's then abandoned by the Federal Government in the mid 1980's. Certificate-of-needs limit competition and have been shown to not hold down health care costs.  

It is often stated that health care dose not respond to the same market forces as other industries. But what else can be expected when prices and quality are hidden form the consumer and providers are assured customers by the granting of State sanctioned monopolies.