At the Intersection of Health, Health Care and Policy Cite this article as: Samuel Metz Consumer-Driven Health Care Health Affairs, 33, no.5 (2014):905 doi: 10.1377/hlthaff.2014.0285
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Health Affairs is published monthly by Project HOPE at 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814-6133. Copyright © 2014 by Project HOPE - The People-to-People Health Foundation. As provided by United States copyright law (Title 17, U.S. Code), no part of Health Affairs may be reproduced, displayed, or transmitted in any form or by any means, electronic or mechanical, including photocopying or by information storage or retrieval systems, without prior written permission from the Publisher. All rights reserved.
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doi:
10.1377/hlthaff.2014.0285
Consumer-Driven Health Care In his Entry Point essay (Feb 2014), William Frist hypothesizes that consumer-driven health care will lower costs and improve health. No data justify that hypothesis. Multiple studies instead confirm that consumer-driven health care increases costs and erodes public health. One study concluded that “as the financial burden of cost sharing continues to rise, patients increasingly avoid necessary care, thereby contributing to the high morbidity and mortality of the U.S. population.” 1 Other studies2 demonstrate that patients seldom make cost-effective choices when given drug plan options. Frist’s optimism may be inspired by markets for durable goods. But health care is not a durable good. Patients who postpone care because of cost find themselves needing more complex, expensive, and perhaps futile care later.3 The RAND Corporation concluded that “when decreases in
utilization are driven solely by costcontainment concerns, they may not occur in clinically sensible ways.” 4 Health care professionals are better judges of health care needs than patients are. Evidence has shown that universal access to care without financial penalty saves more money and generates better outcomes than the consumer-driven plans advocated by Frist. Samuel Metz PORTLAND , OREGON NOTES 1 Braithwaite RS, Rosen AB. Linking cost sharing to value: an unrivaled yet unrealized public health opportunity. Ann Intern Med. 2007;146(8):602. 2 Zhou C, Zhang Y. The vast majority of Medicare Part D beneficiaries still don’t choose the cheapest plans that meet their medication needs. Health Aff (Millwood). 2012;31(10):2259–65. 3 London JA, Utter GH, Sena MJ, Chen SL, Romano PS. Lack of insurance is associated with increased risk for hernia complications. Ann Surg. 2009; 250(2):331–7. 4 RAND. RB4522: assessing the appropriateness of care [Internet]. Santa Monica (CA): RAND; 1998 [cited 2014 Feb 26]. Available from: http:// www.rand.org/pubs/research_briefs/RB4522/ index1.html
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H e a lt h A f fai r s
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The online version of this article, along with updated information and services, is available at: http://content.healthaffairs.org/content/33/5/905.1.full.html
For Reprints, Links & Permissions: http://healthaffairs.org/1340_reprints.php E-mail Alerts : http://content.healthaffairs.org/subscriptions/etoc.dtl To Subscribe: http://content.healthaffairs.org/subscriptions/online.shtml
Health Affairs is published monthly by Project HOPE at 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814-6133. Copyright © 2014 by Project HOPE - The People-to-People Health Foundation. As provided by United States copyright law (Title 17, U.S. Code), no part of Health Affairs may be reproduced, displayed, or transmitted in any form or by any means, electronic or mechanical, including photocopying or by information storage or retrieval systems, without prior written permission from the Publisher. All rights reserved.
Not for commercial use or unauthorized distribution Downloaded from content.healthaffairs.org by Health Affairs on June 17, 2015 at The University of Iowa Libraries
Letters There is a limit of 300 words for letters to the editor. Health Affairs reserves the right to edit all letters for clarity, length, and tone. Letters can be submitted by e-mail, [email protected], or the Health Affairs website, http:// www.healthaffairs.org.
doi:
10.1377/hlthaff.2014.0285
Consumer-Driven Health Care In his Entry Point essay (Feb 2014), William Frist hypothesizes that consumer-driven health care will lower costs and improve health. No data justify that hypothesis. Multiple studies instead confirm that consumer-driven health care increases costs and erodes public health. One study concluded that “as the financial burden of cost sharing continues to rise, patients increasingly avoid necessary care, thereby contributing to the high morbidity and mortality of the U.S. population.” 1 Other studies2 demonstrate that patients seldom make cost-effective choices when given drug plan options. Frist’s optimism may be inspired by markets for durable goods. But health care is not a durable good. Patients who postpone care because of cost find themselves needing more complex, expensive, and perhaps futile care later.3 The RAND Corporation concluded that “when decreases in
utilization are driven solely by costcontainment concerns, they may not occur in clinically sensible ways.” 4 Health care professionals are better judges of health care needs than patients are. Evidence has shown that universal access to care without financial penalty saves more money and generates better outcomes than the consumer-driven plans advocated by Frist. Samuel Metz PORTLAND , OREGON NOTES 1 Braithwaite RS, Rosen AB. Linking cost sharing to value: an unrivaled yet unrealized public health opportunity. Ann Intern Med. 2007;146(8):602. 2 Zhou C, Zhang Y. The vast majority of Medicare Part D beneficiaries still don’t choose the cheapest plans that meet their medication needs. Health Aff (Millwood). 2012;31(10):2259–65. 3 London JA, Utter GH, Sena MJ, Chen SL, Romano PS. Lack of insurance is associated with increased risk for hernia complications. Ann Surg. 2009; 250(2):331–7. 4 RAND. RB4522: assessing the appropriateness of care [Internet]. Santa Monica (CA): RAND; 1998 [cited 2014 Feb 26]. Available from: http:// www.rand.org/pubs/research_briefs/RB4522/ index1.html
May 2 014
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Downloaded from content.healthaffairs.org by Health Affairs on June 17, 2015 at The University of Iowa Libraries
H e a lt h A f fai r s
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