Running Head: CONSUMER DRIVEN HEALTHCARE

CONSUMER DRIVEN HEALTHCARE Trident University International Kevin S. Varner Topics in Health Care Policy BHM 415 Case Study Module Number 4 Coordinator Professor: Dr. Mickey Shachar Core Faculty: Dr. Brad Collins September 07, 2011

CONSUMER DRIVEN HEALTHCARE

The argument has been made that patients do not receive good medical care if they do not have much money. This follows into a discussion about how Consumer Driven Health Care (CDHC) is being touted as the next big thing, completely changing the way the Healthcare system in our country works. This system unfortunately does not take into account certain factors that make CDHC untenable in the long term, and still would support the argument that low income people receive worse health care. CDHC Consumer Driven Health Care is a proposed system in which the consumer decides what medical services they will receive, rather than having an insurance policy dictate the services available, and in some cases required, based on the plan you are signed up for and what your physician recommends. By changing this dynamic costs largely fall to the consumer, as the insurance provider only pays a minimum amount automatically. To offset this increase in cost to the consumer, health care savings accounts of various types would be created. These accounts would be added to by the consumer, as they see fit, and the amount of services they could afford would be based on this account, their income, and the small amount already paid for by the insurance company and possibly by the employer. The idea behind this is that high costs come from large plans that have unnecessary coverage for issues most people never have. By taking away this coverage you decrease the costs associated. Additionally, it posits the idea consumers are being forced into unnecessary tests and procedures by some kind conspiracy between providers and insurance companies. Therefore, by taking the choice of medical care and giving it solely to the consumer, you eliminate waste.

CONSUMER DRIVEN HEALTHCARE

There are numerous arguments against this idea. To start with, it goes to the argument that people with more money will receive better care. If you work for an employer that has matching funds for these savings account, and you have more disposable income to increase your own contributions, your medical care will be greater when you have to tap into this account. If you have less income and cannot afford to add money to these accounts your ability to pay for services is severely decreased. Treating our health as a commodity will lead to a worse situation for the low-income people than we are currently in; consumers get better quality when they pay more. (Rodwin 2003). The converse of this is consumers get worse quality when they pay less. Public Policy Measures The Affordable Care Act, passed a year ago by Congress and signed into law by the President, has many provisions to expand coverage and make health care affordable for everyone. Looking at the model and basis for CDHC, some provisions may be considered antithetical. As an example, the Act requires everyone in America to have health insurance. To assist in this several provisions are enacted to make it affordable. As stated on the government website healthcare.gov: A new health insurance marketplace will be created in 2014. These new health insurance Exchanges will offer one-stop shopping so individuals can compare prices, benefits, and health plan performance on easy-to-use websites. The Exchanges will guarantee that all people have a choice for quality, affordable health insurance even if a job loss, job switch, move, or illness occurs. The new law also provides tax credits to help more Americans pay for insurance. If this continues to hold true, and the movement to de-fund all aspects of the Act is rendered impotent, then some aspects of CDHC will be enacted. Consumer choice will be alive and well in a healthcare insurance exchange, yet rather than being solely driven by monetary concerns as CDHC is designed to be, it levels the field by making some form of healthcare available for everyone regardless of income. This eliminates other issues that

CONSUMER DRIVEN HEALTHCARE

could arise with the other system such as patients deciding not to get certain lab studies, x-rays, or not showing up for follow up appointments against doctors orders. Conclusion Even with the good intentions inherent in Consumer Driven Health Care advocate, the system is not going to fix the health care disparities that exist between those who have money and those that do not. However, some aspects of the concept are very admirable, and when incorporated with the recent legislation, can drastically improve overall health care systems. Moving toward a results based system in addition to increasing coverage for everyone is the best policy that should be pursued.

CONSUMER DRIVEN HEALTHCARE

References Rodwin, Marc (2003) The Dark Side of Consumer-driven health System. Frontiers of Health Services Management; Summer 2003; 19, 4; pg 31. Retrieved from ProQuest. U.S. Department of Health and Human Services (2011) Health Disparities and the Affordable Care Act. Retrieved from: http://www.healthcare.gov/law/infocus/disparities/index.html