(12/20/05) For decades people with health care needs have had little say about what services they receive.  Today patients are rapidly changing from passive receptacles into informed and empowered consumers.  They are demanding more control over their health care and demanding less on their employers, insurance companies and government bureaucrats.

Some federal action taken recently gives patients more say in their health care.  Consumer-driven health plans (Health Savings Accounts) offer patients the tools and financial incentives to shop for economical care.  Most plans combine high-deductible insurance coverage with an employee-patient controlled Health Savings Account.  These consumer driven plans encourage patients to become better shoppers for health care.  Some states give them online access to information on health care providers, quality and costs.  This gives the patient a financial incentive to find cost-efficient care.

Insurers like HealthPartners of Bloomington, Minnesota, provide similar data to its members.  It also includes patient surveys to rank doctors and hospitals on quality, and blends price and quality information to identify providers that might offer the best value.  Such postings will help bring down health care costs.  That’s what happened with LASIK eye surgery.  The disparity in fees shrank as providers began advertising their prices to attract more patients.

Also putting pressure on costs are walk-in mini-clinics. These facilities offer routine health care at bargain prices.  The largest of these, MinuteClinics, which is expanding rapidly, operates small kiosks, located mainly in retail stores such as Target and CVS.

Prices are posted for services and treatment of ailments ranging from strep throat to ear infections.  Fees range from $28 to $110.  No appointments are needed and the kiosks are staffed by nurse-practitioners.  Each kiosk is linked via computer to access guidelines for diagnosis and treatment.  These mini-clinics have the attention of major employers who are contracting with them to cover employees.  Incentives are given to employees as a way to encourage them to use the facilities.  This is the type of competition that’s key to Consumer Driven Health Care.

Technology is spurring further creativity by offering medical care over cell or telephones.  TeleDoc Medical Services charge $35 a call and there’s an $18 registration fee for service plus a monthly membership fee of $4.25 per person and $7 for families.  They operate in all states.  TeleDoc offers 24/7 coverage and guarantees that a physician will respond to a phone call in three hours or the call is free.  After routine questions about a patient’s medical history and symptoms, the physician can prescribe medication (no narcotics) or refer the patient to a local physician or emergency room if the diagnosis is something serious.

Congress is considering a reform (HR 4662) to allow the purchase of health insurance from providers in other states.  One of the biggest cost generators to health insurance are mandates imposed by states.  Currently, over 1800 are in place across the country and health premiums range from being very affordable for a high deductible policy in Kansas City ($172/month) for a family of 4 to extremely high ($771/month) for the same policy in Vermont.

Vermont should repeal its uncompetitive mandates and allow carriers to offer a basic health insurance policy.  If they don’t, new proposed Federal legislation will allow Vermonters more insurance choice and affordable coverage that’s offered in other states.   However, the liberal Democrats in the Vermont legislature oppose consumer driven improvements that empower patients.  They support a single payer government controlled health care approach that enforces a cap on overall health care spending.

There’s no good reason for not having affordable health insurance rates. An elimination of government policy and restrictive practices that aren’t working would be the first step toward affordable consumer driven reform.
 

Frank Mazur
South Burlington

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Frank Mazur is a small business owner and was a member of the Vermont House from 1995-2004. He’s also chair of the advisory board to FreedomWorks.com