February 10, 2010

A Real Life Case for Consumer Driven Health Care

What if everyone cared what the true costs of health care were.  If there were actual consumers of health care like they are for every other purchase in their lives?

Those who have "Consumer Driven Health Plans" are engaged in their health care purchases.  These plans consists of a high deductible health plan ($2,500 for example) coupled with a personal care account such as a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA).  The consumer will use either their HRA or HSA to pay for medical bills before they meet their $2,500 deductible.

Here is an actual real life example of someone on a  "Consumer-Driven Health Plan":

-A woman is on vacation and has an extremely bad sore throat.  She goes to a local urgent care facility to get it checked out.  The doctor takes a quick look at her and writes a script for amoxicillin.  She met with the doctor for less than 5 minutes.  She receives her bill in the mail and the urgent care facility charged her for a "High-Level" office visit at $250.  Amazed at the high price of the 5 minute visit she quickly calls the urgent care facility.  She asks how her 5-minute meet with the doctor for a sore throat was classified under "High-Level?"  The urgent care facility responded, "Oh, I guess that should have been billed at the 'low level' rate for $75, but what do you care? Your insurance is paying it."

Amazing.

Now, if this person had been on a typical co-pay plan or another first dollar coverage plan, they simply would not care about the overcharge (even though they still should, because it will be reflected in premiums).  Why would they care? No matter what the doctors office billed the insurance company you pay the same co-pay.  Consumerism always creates less waste and more savings.

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