The consumer-driven healthcare revolution, trumpeted one conservative think tank a few years back, has only just begun.

Now, for anyone who has ever been inconvenienced by an encounter with the healthcare system or even worse, been on the receiving end of poor quality care, a medical error or a misdiagnosis a greater focus on consumer satisfaction might sound like just the right medicine for American healthcare.

So should we celebrate the recent rise of consumer-driven or consumer-directed healthcare plans? The premise of CDHPs essentially high-deductible plans, with an option for a health savings account is straightforward enough: If you shop for services with your own money, youll use less healthcare and hunt for better bargains, in the process forcing providers to improve quality.

CDHPs have grown rapidly in recent years. From a trivial 4 percent in 2006, CDHPs now account for a full 20 percent of all employer-based insurance plans. The trend seems set to continue in 2014: A survey from the National Business Group on Health last month found that CDHPs were considered the most effective tactic to control rising costs by large employers, with 72 percent already offering a CDHP, and 22 percent planning to offer only CDHPs in 2014.

Id wait to break out the bubbly, for, despite the utopian claims of its enthusiasts, CDHPs are more about cash than quality, more about cost shifting than consumer empowerment.

The consumer-driven healthcare revolution, it turns out, is likely to be neither revolutionary nor consumer-driven, but instead will only manage somehow to make the misfortune of getting sick an even worse experience.

One irony of the current craze with consumer-driven care is that its adherents seem surprisingly unaware that we already had an experiment with true market medicine in this country in the 19th century.

From the beginning, argues the legal professor T. S. Jost in his critique of the consumer-driven movement, Health Care at Risk, there was only consumer-directed health care in the United States. Patients paid out of pocket, there was no health insurance, and there were an impressive variety of equally ineffective practitioners, frequently engaged in brutal competition.

The system (if it can be called that) was basically a disaster, with the presence of a healthcare marketplace doing little to encourage quality in that golden age of quackery. What ultimately did improve quality at least to some extent was good old-fashioned regulation: medical licensure laws, the closure of low-quality medical schools, the Pure Food and Drugs Act, and so on.

Meanwhile, the poor of that era were generally left at the mercy of scattered and frequently inadequate charitable facilities if they were lucky. In later years, hospitals would not infrequently reject or otherwise dump sick patients deemed poor financial investments, a notorious practice that wasnt really addressed again, with regulation until the Emergency Medical Treatment and Active Labor Act of 1986.

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The right’s health care “revolution” is a scam

Sector exchange-traded funds, or ETFs, allow nervous investors to sample from the fast-paced health care industry with lessened risk. But how do you choose the best health care ETF for your portfolio?

ETFs exist for every aspect of the health care industry including medical devices and insurance companies. But the standouts focus on either a mix of drugmakers and biotechs or an all-biotech buffet.

Here are three sector ETFs to consider.

1. A broad bundleVanguard Health Care ETF (NYSEMKT: VHT) tracks the MSCI US IMI Health Care 25/50. The ETF contained 293 stocks as of the last quarter. Pharmaceuticals accounted for more than 40% of the holdings, with biotech coming in second with 19.4%. That's reflected in the five largest holdings: Johnson and Johnson, Pfizer, Merck, Gilead (NASDAQ: GILD) , and Amgen. Vanguard's ETF is up 27.74%, as of September 5 pre-market.

This ETF has a well-balanced top five. Johnson and Johnson, Pfizer, and Merck are all Dogs of the Dow , and the former two in particular have enough segments to withstand a hit here and there.

Gilead is up more than 100% in the past year. The company stands at the forefront of the much-anticipated all-oral hepatitis C treatments and has historically led the market in HIV drugs. Amgen leads a new class of cholesterol medications that could step in where statins fail.

The ETF has an expense ratio of 0.14% and an average volume of around 170,000. Vanguard offers commission-free trading on its ETFs.

2. Large piece of biotechSPDR S&P Biotech ETF (NYSEMKT: XBI) tracks the S&P Biotechnology Select Industry Index. Holdings include 56 biotech companies with Alnylam, Incyte, and NPS Pharmaceuticals at the top. The ETF is up 42.59% year-to-date.

The ETF's top holdings represent companies still on the brink of breaking out in a big way. Alnylam's potential lays in its RNAi therapeutics and discovery methods, which could revolutionize the biotech industry. The company has a 5x15 program, which hopes to have five drugs in clinical development before 2015. Incyte focuses on cancer and inflammation treatments,and its stockpopped last month following positive mid-stage trials for metastatic pancreatic cancer. NPS had a strong launch for its short-bowel syndrome treatment and should soon submit regulatory paperwork for a hypoparathyroidism treatment.

This biotech spider has a gross expense ratio of 0.35% and an average volume of around 305,000.

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3 Lower-Risk Ways to Invest in Health Care

NEW YORK (AP) -- Health care is an alphabet soup of abbreviations and acronyms, and the ways one can save to pay for medical care are no different. Here's a breakdown of health care savings plans:

HSA:

Health Savings Account. Think of it as a 401(k) for health care. An individual sets aside money, pre-tax, into a special bank account that can be used for medical expenses. Companies often make contributions to the account for their employees. HSAs are portable, meaning they can be taken with the employee when they leave a company. If used correctly, HSAs help lower taxes three ways: the contributions reduce your taxable income, gains from the invested money are tax free, as are withdrawals for eligible medical costs.

HRA:

Health Reimbursement Arrangement. A company sets aside money to pay for an employee's eligible medical expenses. While some plans allow an employee to roll over the balance year to year, an employee cannot contribute to the account and the amount of money is typically not portable. Eligible health care expenses reimbursed by the employer are considered tax free for the employee.

FSA:

Flexible Spending Account. An employee sets aside pre-tax dollars in an employer-sponsored account to pay for health care expenses. The key feature of a FSA is "use it or lose it." An employee must use all money in his or her account during the coverage period (typically a full year) or forfeit any leftover money. FSAs also exist for mass transit costs and child care expenses.

HDHP:

High-deductible health plan. A type of health insurance that has a minimum deductible of $1,200 for individual coverage or $2,400 for family coverage. HDHPs are primarily used to cover catastrophic illnesses and medical emergencies. HSAs can only be used with HDHPs. Another name for HDHP is "Consumer Driven Health Plan" or CDHP.

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A look at health care savings plans