The market usually finds an answer...

I have always wondered how health care costs could continue to defy gravity. One reason is that we always want to get the very best care when we are able. This is why I think we frequently hear so-and-son's heart doctor is one of "the best in the business".

Because modern medicine is beyond most of us, we assume physicians are almost a super-breed of human, whose skill alone determines our future.

Enter reality. Especially in rural areas like mine. Over the years, many of our health care professionals (in fact 100% of ours) are immigrants. The work in small communities because they are willing to do so for lower pay than most American doctors.

This may be just the first economic response to exorbitant health care. More and more Americans may realize that simple competence will suffice when it comes to procedures like bypass or back surgery or cancer treatment.

This idea is demonstrated in the rise of medical tourism. Traveling to Third World countries for drastically cheaper medical procedures is a rational answer to our health care cost crisis. [Note the "Price Guarantee"!!]

[BTW - why Brad and Angelina are birthing in Namibia, I have no idea. Maybe they are really cheap - who knew?]

Not only are the doctors pretty much the same as the ones some of us would depend on here, the almost complete absence of insurance hassles and litigation vultures means very low overhead. In fact, some forward thinking health providers are looking into outsourced medical care.

My conclusion: health care is not a special economic activity. It could be that the same forces reshaping software development can deflate the bloated health care industry. We could see the emergence of a cash-basis health care delivery system that is reasonable enough - thanks to $10,000 heart bypass procedures - that more Americans will save up to self-insure. Opting out of our third-party payer system essentially does an end run around legislators and the health care industry both, and best of all, places a clear price on patient responsibility for our own health.

Relinking economics with our health would help Americans make better choices in lifestyle. It would also demystify a system that preys overmuch on our fears.