Stanley Feld M.D.,FACP,MACE
As the healthcare debate heats up the meaning of consumer driven healthcare (CDHC) needs repeating. The true meaning of CDHC has been bastardized by the healthcare insurance industry as represented by Health Savings Accounts (HSA).
The healthcare insurance industry feared that if Medical Savings Accounts dominated it would lose control of the initial healthcare premium dollars. The result would be a decrease in profit and an increase in price competition and real price transparency.
The reality would be America would have universal healthcare in a more efficient healthcare system. The system would be more efficient because it would be driven by the consumer for their benefit and not a third party payer. A more efficient system will maintain healthcare insurance industry’s profit while permitting a decrease in healthcare system costs.
“A lack of consumer understanding has contributed to the glacial growth of consumer-driven plans. Can better information from health plans help CDHPs take hold?”
HSAs place limits on consumers’ incentives. All of the healthcare premium dollars are eventually paid to the healthcare insurance industry.
Our economic recession along with increasing unemployment have set the stage for consumers to accept any help government will provide. Enter a single party payer and all its problems. Since Medicare and Medicaid have proven to be unsustainable, it is foolish to throw money at a failing system. It is time to revitalize the system.
Just the opposite should be occurring. CDHC should be promoted and not be marginalized. President Obama’s universal healthcare with a single party payer system marginalizes CDHPs. The route he is taking to achieve everyone’s goals and will not repair the healthcare system.
“The idea behind consumer-driven health plans is to transform members into healthcare consumers through education and place more responsibility on the individual.”
Health Saving Accounts (HSA) do little to encourage patient responsibility or make patients informed consumers. HSA were a political compromise designed by the healthcare insurance industry. The resulting plan gutted the intent and effect of the CDHC movement.
“ Studies show that the percentage of Americans insured in CDHPs is still in the single digits, largely for two reasons: Consumers simply don't understand the tax-free savings accounts that are connected to CDHPs, and few health plans are providing cost and quality information to allow consumers to compare doctors, hospitals, and treatment options.”
Consumers do not see a financial advantage of the HSA because there are none. The money has to be used to pay present deductibles and future deductibles. There is no reason the future deductable will not be increased reducing the present value of the money in their health savings account. The healthcare insurance industry wants health savings accounts to fail. It feels its margins are presently excellent and does not need a change.
“More than one-quarter those respondents said that HSAs are difficult to open/manage, or too complicated, or they simply didn't understand the accounts.”
Consumer driven healthcare is the only thing that can repair the healthcare system. It would take control out of the healthcare insurance industry’s hands. The route to take is the ideal medical saving accounts.
Healthcare insurance would convert to real at risk insurance. Consumer would own and control their healthcare dollar. The government could teach the consumer to use the healthcare dollar wisely. The government could provide clear price and quality transparency. It would force all the secondary stakeholders to compete for the consumers’ healthcare dollar. This competition would force an increase in efficiency and decrease in administrative waste.
The government should act as the facilitator for the competition. The time has come for politicians to do something for consumers and not for secondary stakeholders.