12/16/2005 2:22am, #1
- Join Date
- Oct 2004
- Kansas City - the mecca of civilization
Consumer driven health care - about effing time
If you think it is ridiculous that your health care insurance money goes to pay for some jackass that doesn't take care of themselves, then here you go: consumer driven health care. Let's say your employer gives you 2K a year to spend on your health care as you please...and if you don't spend it on health care, you get the money.
Since our capitalist society is driven by money, then making a person's health directly affect their income is just brilliant. If you want to eat **** food, not exercise, and get a gastric bypass, then you have to pay for it. If you get diagnosed with hypertension, then exercise and eat well while taking a generic medication (to cut cost), then you get your health plus more money in your pocket.
And hey, even TBKen won't have to pay insurance money so that some hippy has acupuncture insurance coverage. If they want it, they can pay for it themselves...and save themselves money in the long run BIOTCH!
Could you imagine that people would actually care about efficacy vs. cost? Amazing.
If I support this, does that make me a conservative?
Original article (easier to read with pretty charts): http://www.ncpa.org/pub/st/st276/st276a.html
Consumer Driven Health Care: The Changing Role of the Patient
Consumer driven health care is a new paradigm for health care delivery. Defined narrowly, consumer driven health care refers to health plans in which individuals have a personal health account, such as a health savings account (HSA) or a health reimbursement arrangement (HRA), from which they pay medical expenses directly. The phrase is sometimes used more broadly to refer to defined contribution health plans, which allow employees to choose among various plans, often with a fixed dollar contribution from an employer. Those who opt for plans with rich benefits may have to contribute a significant amount of their own money in addition to an employer’s contribution. Those with more basic coverage contribute less of their own money.
“People with personal health accounts have economic incentives to better manage their own care.”
More choice and greater control over one’s health plan are characteristics of a consumer-driven health care market place.1 People with personal health accounts have economic incentives to better manage their own care. The reason: In addition to health benefits, they realize economic rewards for making good decisions and bear economic penalties for making bad ones. These economic incentives make patients more likely to seek information about medical conditions and treatment options, including information about prices and quality. Patients will respond to these incentives in different ways. Some will seek information about diseases, treatments and health care providers over the Internet, including comparative information about treatment outcomes of individual health care providers and the fees they charge. Some may bypass primary care physicians and directly order their own diagnostic tests or seek online consultations. Others may bypass brand name drugs and obtain less expensive generic substitutes, therapeutic substitutes and over-the-counter drugs. In general, people will consume fewer medical services, and pay less for health care in the long run when they are spending their own money.2
By contrast, most patients have few incentives to be prudent consumers of medical services in the current health care system. The reason: Third parties — government, employers or insurance companies — pay for about 86 percent of all health care.3 As a result, the economic incentive for patients is to consume medical services until they are worth only 14 cents on the dollar. [See Figure I.]
“Third parties pay for about 86 percent of all health care.”
Excessive physician visits is one way in which patients waste health care dollars. Up to one-quarter of physician visits are for conditions patients could easily have treated themselves, according to employee benefits experts.4 A recent report by the Agency for Healthcare Research and Quality even suggests that an annual physical is of little value.5 Patients also waste money through nonemergency visits to hospital emergency room. Even though these are one of the most costly ways to obtain routine treatment, 55 percent of the 103 million visits to hospital emergency rooms are judged unnecessary. Overall, the total cost of unnecessary physician office visits and unnecessary emergency department visits is just under $31 billion annually, or about $300 per American household per year.6
If third-party payment for medical bills is so wasteful, why do Americans rely on it so heavily? The main reason is tax law. Employer payment of health insurance premiums is excluded from the taxable income of employees, a subsidy worth up to 45 cents on the dollar for many workers.7 Yet, until recently, employer deposits to an employee owned and managed health savings account (HSA) were fully taxed — meaning government took almost half the deposit for the middle-income workers. Thus, the tax law generously subsidized third-party payment of medical bills but penalized deposits to accounts used to purchase care directly. As a result of legislation that became effective in 2004, these perverse incentives are finally changing. [See Figure II.]
12/17/2005 8:22pm, #2
- Join Date
- Apr 2004
- I'm surrounded by farms in middle america.
It appeals to me on a personal level but I don't like the idea because often times, any serious medical emergency could suck 2K dry in about an hour. Not all medical expenses are driven by "lifestyle choices."
While there should be a carrot & stick to encourage good health, I don't think this is the answer. Maybe a discount/bonus for good health & semi-annual checkups or somesuch, but the consumer driven drivel just doesn't work. (and I'm an economic convervative)
As I understand it, Insurance works on the basis of everyone won't be sick at once, so those that are well pay the bills for the few that are sick (in theory). I don't think the consumer model you propose takes into account the economics of scale that our current insurance model takes advantage of.
/I'd expand further, but I've got to go meet a beautiful woman in 20 minutes.
12/17/2005 8:30pm, #3
Wow. I wish they had something like that up here. I owe Medical services plan like, $800....for nothing. I haven't seen a doctor in about 4 years, yet they continue to bill me.
12/18/2005 12:30pm, #4
- Join Date
- Oct 2004
- Kansas City - the mecca of civilization
Yeah there obviously would be some bugs to work out such ER visits from accidents. But I think it is a better place to start then with what we have now.
I've actually heard the "...don't worry how much, we'll just bill your insurance..." too many times.
12/18/2005 3:47pm, #5
I'd have to see more specifics, but I think the basic idea is fine. So long as every person has access to health coverage, then I'm happy. If people choose to squander their medical money on booze and hookers, then they're up **** creek and that's okay by me. If they want to spend their money on ho-hos and yoo-hoo, then yeah, they can eat my ass when they need a wheelchair to get around town.
However, if people are simply going to waste this money, why give it to them in the first place?
12/18/2005 5:17pm, #6
There would have to be a commensurate adjustment in education to address a consumer-driven health care system.
Just like if citizens had a greater say in their retirement planning with Social Security. If you give them greater control without education, then you either have to let them suffer and die, or spend more money to care for the people who frittered away their cash and now burden the system.
But I like the general idea, as I have the means and capabilities to best determine my health needs.
12/18/2005 5:57pm, #7Originally Posted by bekaYou can't make people smarter. You can expose them to information, but your responsibility stops there.