Archive for June, 2005

Opposing Camps Wage War Over Consumer-Driven Healthcare

June 23rd, 2005 by Melanie Matthews

Guest Blogger: Jennifer Millman

The battle over consumer-driven healthcare transcends industrial boundaries. Most recently, war was waged over my parents' white Formica kitchen table in the first father-daughter face off of its kind –self-insured employer versus parentally-insured dependent.

Lacking in personal healthcare experience, I was a rebel force opposing a veteran healthcare antagonist. Having presided over a small- to medium-sized wholesale company for the last twenty years, my father has been routinely affected by changes in the healthcare industry – managed care, provider networks, cost-shifting, pharmacy benefit management, increased premiums – that have resulted from an attempt to control out-of-sight healthcare costs.

In this particular battle, my father took the first shot:

"What's consumer-driven healthcare? It's just a high-deductible plan. You choose your treatment, that's the consumer part, but the deductible for that treatment is so high that it ends up limiting your purchasing power anyway."

Apparently, healthcare industry representatives are prepared with a rebuttal. Just last week, HIN sponsored an audio conference on health toolkits, empowering consumers through education. One of our speakers, an established consultant with the eighth largest insurance firm in the United States, neutralized my father's defense in four sentences:

Consumer-driven healthcare is often misunderstood to represent high-deductible, account-based health plans, including health reimbursement and savings accounts. Many large employers have told me they "hate" consumer-driven healthcare. What they really hate is cost-shifting – imposing a high deductible on an uninformed population. That makes sense.

It does make sense.

I've heard similar grievances from other employers struggling with double-digit cost increases seemingly beyond their control. Given excess service utilization, hospital expenses and lost productivity generated by often-preventable conditions, I respect their complaints.

High-deductible consumer-driven health plans may not appear economical in the short-term, but ultimately, they encourage the needed employee health consciousness to reduce gratuitous expenditure and keep employers' bank accounts in check. Lifestyle incentives, health coaches, disease management programs and e-visits –these initiatives are all products of and for the evolution of consumer-driven healthcare. Contrary to popular misconception, these programs don't intend to impose high-deductibles or complicate the system for employers. They may not offer immediate cost-consolation, but with a little enterprising experimentation they just might make things easier.

I may not have much experience in my own health insurance, but I'm learning employers can have relationships with consumer-driven healthcare outside the realm of animosity.