In contrast to much of the rest of the U.S. economy, our health care system is a cobbled, poorly coordinated system. Health insurance is provided largely by government and by employers. Do employers, who have lots of experience with well working markets, have market-based solutions for health care problems?

Our guest today is Helen Darling from the National Business Group on Health. The National Committee on Quality Assurance recently honored her for her leadership promoting health care quality as an issue of commercial competitiveness. She has helped American businesses become better purchasers of health care and has helped government and industry leaders understand the economic importance of health care quality.

Dramatic increases in health care costs have been major problems for U.S. employers hurting growth and competition. Despite the high costs, the quality of care is uneven. Too often, Americans get care that is either less than optimal or that makes things worse. No one solution may solve this. There are dozens of potential solutions that can help. Large employers can help identify key targets, can provide onsite health support, and can encourage employees to participate in condition management.

The lack of personal responsibility for health care costs is a central problem in the US health care system. Our system literally provides a blank check for health care coverage with little to no incentive for patients or their doctors to consider cost. This results in utilization that is off the chart. The Choosing Wise Initiative identified five overused interventions that don’t add health. People should realize that some preventive tests and procedures may not be helpful and that a healthy lifestyle is.