Consumer Directed Health Plans It’s really just a big cost shift from employers to employees It’s WRONG, WRONG & WRONG!

You do not have to be a brain surgeon to understand that when consumers have financial barriers in seeking health care services (higher out-of-pocket expenses) they seek less care – DAH!

The Whole Concept for minimal out-of-pocket expenses for patients seeking medical care was to encourage them to seek care at the earliest onset of a disease for medical reasons. Early detection and treatment of medical problems such as Cancer can actually save the patients life and reduce costly medical treatments and procedures.

I guess the Consumer Driven Health Plan industry cares more about making a buck then they do about saving a life. They’re really a pathetic group of bean counters.

Sometimes I wonder what kind of people devise insurance products like Consumer Directed Health Plans with High Deductibles and huge Out-Of-Pocket expenses. These people are bright and they know what they are doing restricting Access to care and killing people? How do these people look at themselves in the mirror in the morning? What kind of people are these?

There is no medical reason in the world why anyone needs to die prematurely because they do not have health insurance. But 18,000 Americans die each year because they lack basic health insurance coverage – its despicable, its inhuman and downright WRONG.

TENNESSEAN.COM

Wednesday, 07/04/07
When patients pay more, they use less medicine, study finds
Higher costs may lead to more trips to emergency room

By NICOLE OSTROW
Bloomberg News

NEW YORK — When patients pay more for prescription medicine, they use it less, according to a finding that researchers say may spur more serious illnesses over time.
Consumers spend 2 percent to 6 percent less on prescription drugs for each 10 percent rise in their out-of-pocket costs for such things as rising deductibles, the amount paid upfront for insurance-based health care, said a review of 132 studies released Tuesday by the Rand Corp., a Santa Monica, Calif.-based public policy institute.

Consumer outlays are rising as companies seek to hold the line on spending by raising deductibles and offering their workers co-insurance plans that split costs. A study this year in the journal Health Affairs indicated that consumers may spend $440.8 billion out of pocket in 2016, or 76 percent more than in 2006. More study is needed to determine whether such an increase will push consumers to forgo necessary treatment, researchers said.
“For patients with certain chronic illnesses, when you increase cost sharing on the pharmacy side, you end up with more hospitalizations and more use of emergency departments,” said Dana Goldman, the lead author.
Goldman said his analysis, presented today in the Journal of the American Medical Association, also found that certain cost-containment programs, including requiring that patients get a note from a doctor for a specific medicine, don’t affect general pharmaceutical costs.
The analysis included research on prescription drug cost-saving strategies that include use of co-payments and monthly prescription limits. The results build on a 2004 Rand finding that said doubling drug co-payments decreased use of eight classes of medicines, including diabetic treatments, which dropped 25 percent, and prescription painkillers, which fell 45 percent.

Billions spent on drugs

The latest Rand report suggests that businesses and the U.S. government need to better understand how patients will respond to cost-saving measures before choosing new directions for health-care spending.

“These findings make benefit design an important public health tool for improving population health,” the study authors wrote.

“The challenge for public and private plans is to make patients more sensitive to the cost of treatment without encouraging them to forgo cost-effective care.”
Prescription drug spending in the U.S. was $200.7 billion in 2005, up from $40.3 billion in 1990, according to a May report by the Kaiser Family Foundation. It is expected to increase to $497.5 billion by 2016.

Consumer plans debated

One cost measure that’s been controversial is so-called consumer-directed health plans. The plans feature higher out-of-pocket limits and deductibles for consumers in return for lower insurance premiums.

President Bush and Congress supported the concept in 2003 by giving tax breaks to people who link the consumer-directed policies to health-savings accounts from which medical costs can be paid. The accounts are funded by employees and, in some cases, supplemented with employer contributions.

Supporters argue that the plans motivate members to shop for the best care at the lowest cost and that they will spur many of the 45 million uninsured Americans to buy private health plans.
Doubters say consumer-directed plan enrollment, now about 4.5 million, is slowing because it isn’t a good deal.

“It’s really just a big cost shift from employers to employees,” Thomas Carroll, an analyst with Stifel Nicolaus Co. in Baltimore, said in a telephone interview Tuesday. “You’re still on the hook for first-dollar coverage to a greater extent than before.”

Goldman said his research suggests that such plans need to include exceptions to the high deductibles for generic drugs and medicines that are known to work and keep people out of the hospital, like cholesterol-lowering agents called statins.

“You may want to encourage cost sharing for some drugs, but for medicines that can forestall expensive complications, like statins, you really want to charge less, maybe zero,” he said. “The best policy may be to give them away.”