Here’s the health care consumerism dilemma in one neat, small, understandable package.
Advocates of consumerism in health care argue that forcing folks to pay for their care will make them better consumers, and thus reduce costs. Theoretically, that makes sense – if you have to pay for something you won’t get more than you need, and you’ll keep yourself healthier to keep your costs down.
Yet another study (yes, there are more than one) shows that when individuals are required to pay more for their drugs, they don’t take them as they should. This leads to all kinds of nasty physical and financial problems – e.g. more strokes, which cost lots of money to fix, when all the patient had to do was take their blood pressure meds.
This isn’t some schlocky faux-objective think tank, but the RAND Corporation. Here’s the money quote:
“The findings from studies focusing solely on the chronically ill are unambiguous,” Goldman said. “Greater use of inpatient and emergency medical services are associated with higher co-payments or cost-sharing for prescription drugs.”
At least as far as drug copays go, increasing consumers’ costs actually drives up health care costs. It’s not much of a leap to think individuals with high deductible plans will wait to go to their docs to see if those skin blotches just go away on their own. So much for theories.
Which leads to another question; if consumerism does not work to reduce total costs, why are its advocates such strident supporters?
Methinks it has nothing to do with finances, and everything to do with philosophy. And that ‘philosophy’ goes by such names as ‘libertarianism’ and ‘freedom of choice’ – a belief that each person should make their own way in the world under their own power.
I’ve no problem with advocates arguing for a position, as long as their arguments are not hidden behind false pretenses.
Before the hate mail from self-styled free marketeers comes flying in, know that I believe cost-sharing can help instill better buying behaviors. But the current huge deductible version of CDHP is doing more harm than good. If consumerism-driven reformers are really interested in addressing health care reform, they should carefully consider when, how, and why cost-sharing makes sense.
Because their current arguments don’t hold up.