We Have the Greatest Healthcare System in the World and Here's Proof That it's Getting Even Greater

FORT WAYNE, Ind. -- Last year Russ Moore Transmission Inc. adopted a health-insurance plan in tune with the "consumer driven" philosophy President Bush has been touting. The plan requires employees to pay as much as $5,250 a year in medical costs out of their own money before insurance kicks in, with the goal of turning them into savvy shoppers for doctors and drugs.

The new strategy has motivated some workers to research what they are paying for medical care. One found an over-the-counter replacement for a more expensive brand-name heartburn drug. That is good news for Nick Bond, who runs the business and had suspected some employees were overusing medical care because they didn't have to pay for much of it themselves.

The bad news: The employees' research often consists of going to Mr. Bond and asking for his help, even after they have had 19 months to get familiar with the plan. At one point, he and his office manager had to hole themselves up in their offices for about two weeks developing a spreadsheet with price information on 32 drugs.

Mr. Bond's experience suggests that although information about the price and quality of health care remains sketchy, the president's push to make the health-care market more like the market for other services can change consumers' behavior. However, some managers have to turn themselves into instant experts both on health care and on the law. Mr. Bond knows about a transmission rebuilder's heartburn, a technician's blood-pressure medication and a visit to the emergency room by a mechanic's daughter. If he uses health information in firing or demoting an employee -- or is perceived to do so -- he might be in for a lawsuit.

"There are things I'm not supposed to know -- but I know," says Mr. Bond, who is part-owner and general manager of the company previously run by his father-in-law.

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