A series of articles in Health Affairs address the question of whether high-deductible "consumer-driven health care" (CDHC) plans will keep consumers from seeking needed care.
Health Affairs also includes the following perspectives on the new studies.
Marjorie Ginsburg, executive director of Sacramento Healthcare Decisions. “It is not likely that CDHC will add to the serious debate that Americans must have to reach a just, efficient, and effective health care system,” Ginsburg says. “In the end, the big-picture questions about health care coverage will have to be asked and answered by many voices, not addressed through an individual’s personal treatment decisions. Regardless of a patient’s willingness to pay a high deductible, should health insurance cover a promising cancer drug costing $100,000 a year? Should insurance pay $1,500 for a scan to diagnose Alzheimer’s disease when no cure is available, or pay for extensive medical work-ups for adults without risk factors or symptoms?”
John Goodman, president of the National Center for Policy Analysis. Goodman argues that the authors ignore the fundamental fact that “health care has to be rationed.” He states, “Someone must choose between health care and other uses of money”; the answer given by CDHC is that the patient should choose. He notes that in cosmetic surgery, where consumerism governs, the typical patient can “(1) find a package price in advance covering all services and facilities, (2) compare prices prior to the surgery, and (3) pay a price that is lower in real terms than the price charged a decade ago.”
Peter Lee, CEO of the Pacific Business Group on Health, and Emma Hoo, PBGH director of value-based purchasing. Lee and Hoo say that CDHC “is only one component of a broader quality-based benefit design strategy” that is needed to promote better quality and hold down health care costs.
Tony Miller, managing director of Lemhi Ventures and cofounder of Definity Health says CDHC “is about a change in the way we are going to finance our consumption of health care services so that users of those services have more control over how the dollars are spent.” Miller criticizes the new papers for “pining for a past that never existed” in which “utopian conditions of quality and cost predated CDHC.”
Murray Ross, Kaiser Permanente director of health policy and research, suggests that disease management conducted through organized provider groups and delivery systems is more likely than higher premiums or deductibles are to effectively cut costs.
Consumer-driven plans have been pushed by the Bush administration as a health policy solution.
Posted by schwitz at October 24, 2006 09:46 AM | TrackBack