High Deductibles & Patient Behaviors----Is There a Clear Benefit to the US Health Care System?

-----By Anna Shepherd, Health & Personal Finance Professional

As health care reform enters into its next year, many employees will notice that a side-effect of reform has made their employer shift a bigger portion of costs to them. Is that a good thing or a bad thing, in general?  See the linked article:  http://www.statesman.com/news/business/higher-health-insurance-deductibles-giving-workers/nhnB4/

It may depend on the employee or consumer himself and the motivations that cause human beings to do some things and avoid doing others. This high deductible scheme works ideally with an educated populace. I am a vociferous proponent of free market reforms in health care; certainly high deductible plans are step in the right direction. However, if there isn’t also an affordable intermediary such as a personal health-advisor, the result will inevitably be higher costs for more acute episodes. 

The old adage holds true that an ounce of prevention is worth a pound of cure.

Working in health care, it is sometimes difficult to remember that many people have little to no working knowledge of the industry or even basic human anatomy and health. I constantly have to remind myself that someone coming into my facility with a family member may know as much about healthcare as I know about carburetors! It will take time, possibly time this current system doesn’t have, for the patient population to become proactive and assume responsibility for knowledge of their health.

Maybe there is a bright side in that the younger, cash-strapped generation that demands information/services be accessible online and at low or no cost, can use sites like WebMD to avoid unnecessary trips to the doctor or ER. Over time, I’m optimistic that enough of a portion of the US population will invest the time to learn about their health needs and act as rational consumers, to provide a net gain to the system. The downside is that there is also a significant portion of the population who lack the ability to meaningfully use health resources by themselves. Further, this cohort is usually sicker and costlier to the system.

This brings me to my overall impression of the transition to high-deductible plans: it will ultimately be very burdensome to the system because there is effectively no market providing affordable and meaningful health consulting services to the populations that will most need them.  It will take too long to implement such services. Meanwhile those higher-risk people forego preventive services to save their money, costing the system more in the long run.

Anna is a health care and finance professional, working on the health care provider side in an administrative capacity.