(cross-posted at Cure This, an online health justice space)
Ah yes, another discussion of consumer-driven healthcare, written by someone from an insurance company (no conflict of interest there?):
A recent study by Fidelity Investments found that while 61 percent of employees considered their understanding of health insurance terminology to be very good, only 15 percent of workers had a very strong understanding of key terms. For instance, 56 percent did not know what an HSA is; a startling 13 percent did not know what a co-payment is.
Ok this is SCARY. If more than 1/2 of Americans don't know what a Health Savings Account is, and 13% don't know what a co-payment is, how are Americans equipped to shop around for their healthcare? (more after the jump...)
In the same vein, price transparency is critical for empowering consumers to make appropriate choices for themselves and their families. Standard pricing is not new to the medical profession -- dentists provide it, as do veterinarians. Services not covered by traditional plans, such as laser eye and cosmetic surgery, already do. Consumers deserve reliable information about the comparative prices and quality of health care-related goods and services. Believe it or not, they can be trusted to make the right decision.
But wait, they don't even know what a high-deductible account is (read: you MAY pay the first 5,000 or 10,000 of your medical bills for a year depending on which HSA you choose). And tricky tricky, nice framing work done here. By saying that Americans "can be trusted" to make the right decision, you're placing patient-advocates who think Americans are being duped by the complexity of these high-deductible plans in the position of calling Americans DUMB. There's an interesting game at play here.
A common objection to price transparency is that you can't negotiate fees when your loved one is having a heart attack. But the majority of medical procedures, office visits and routine surgeries are planned weeks or months in advance, with enough preparation time for a patient to decide which doctor to consider and which hospital to use. For instance, in a recent article on shopping for health care, the Minneapolis Star-Tribune reported a $10,000 price disparity in the cost of routine cataract surgery among three area clinics. If patients can choose a hospital based on reputation, location, convenience to home or office, they ought to be able to put price into the equation, as well.
Sure, it's wonderful to be able to choose the more affordable option, and it's completely bizarre that there exist so many disparities in the costs of procedures. It's empowering for individuals to know this information. But STILL, I think the majority of fees that are thrown at patients are from more urgent or emergent situations... situations that you don't have the time nor the energy to necessarily "negotiate" on.
In an era when premiums are rising faster than inflation and salaries, consumers are just as concerned about the costs of procedures to insurance companies as they are to themselves. Detailed billing helps catch mistakes that can drive up premiums. Knowing the real cost of a CAT scan or MRI may help consumers contain the urge of doctors to order unnecessary tests.
Ah yes, those test-hungry doctors, they just can't CONTAIN themselves. There's no doubt that many doctors may order more tests than necessary. But instead of thinking about how we can create a better evidence-based system of what physicians order, etc, we're talking about empowering patients to decide whether they should get the MRI that their doctor thinks they should have for their neurological symptoms. Something seem a little crazy here?
...Consumer-driven health plans are about more than shifting costs and reducing premiums. Because they require the active engagement of the consumer, it is an about-face from the traditional ways we think about health services delivery. With appropriate support in the form of education and training, we can change the behavior of the consumer from that of a passive recipient of services to an educated, informed and empowered partner in health.
Again, the terminology is enough to make anyone think HSAs are a great thing (heck, I'd want to be empowered and not a passive recipient). But on the contrary, The Commonwealth Fund shared testimony (exec summary and .pdf of testimony) they gave to Congress about HSA's that insurers don't like to share, including the fact that many people with HSA plans forego their care because so much of it is paid out of pocket before one cent is paid by the insurance companies, and that often-times HSAs benefit the rich and healthy significantly more than low-income folks, not to mention the low rates of satisfaction with such plans.
Check out the expert testimony before you believe everything an insurance salesperson tells you. I mean, you DO want to be empowered, right?
You can share your thoughts on the matter below in the comments section, or directly with the author of the piece on consumer-drievn health care, whose email address is provided in the article.
Glossary (from Wikipedia): Health Savings Accounts, High Deductible Health Plans