Nearly three years ago, we talked about Consumer Centric Healthcare here at AVC. I keep coming back to this central idea:
a guiding principle of any reform should be to put the consumer, not the insurer or the government, at the center of the system.
So when I read this morning in the NY Times that medical costs have been leveling off over the past few years, it got my attention.
I particularly like this part of the Times article:
Many experts — and the Medicare and Medicaid center itself — point to the explosion of high-deductible plans, in which consumers have lower premiums but pay more out of pocket, as one main factor. The share of employees enrolled in high-deductible plans surged to 13 percent in 2011 from 3 percent in 2006, according to Mercer Consulting.
I’m a huge fan of high deductible plans and think that they, along with some sort of health savings account that rolls over unused account balances, is a big step in the right direction to put consumers in control of their own medical expenses and decision making.
There are other things that would be part of a comprehensive consumer centric approach, including wellness incentives (ideally driven by self monitoring/reporting technology), accountable care, and efforts around education and transparency so consumers can make their own decisions. Clearly the Internet can make big contributions in all of these efforts.
It is ironic that consumers are starting to take control of their own medical spending at a time when our country and our courts are debating the wisdom of a large expansion of our government’s role in our medical care. It reminds me of the adoption of the open source model in software at the same time as the government’s case against Microsoft. Guess which one had the bigger impact?
None of this should suggest that I am against providing for those who cannot afford their own care. We can and should do that. But there is a difference between the funding mechanism and the decision mechanism in health care. The latter should be in the hands of the consumer as much as possible in order to restrain health care costs and maintain/improve the quality of care in this country.