…the US isn’t even close to being the leader in consumer-driven medicine, if by that you mean cost-sharing and purchasing decisions; in the rich world, that would almost certainly be Switzerland, where consumers patients not only pay heavily out of pocket, but purchase their own insurance, as both Kaiser and Cato will tell you.
…a Swiss-style system of universal coverage would be a vast improvement on what we have now [pre-ACA, at the time]. And we already know that such systems work.
Niklas Blanchard had an excellent post, “Sometimes Patients are Consumers…” And Will Wilkinson comments.
Even in a system such as the French, actual health care decisions are very often driven by choosing individuals, even if government ends up paying the bill.