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Challenges and Choices
for Health Care Consumers
Throughout the 2004 presidential campaign, voter surveys and
opinion polls consistently indicated that the future of health care coverage in
the United States ranks among the most important concerns that the nation will
be facing during the next four years. Rating the issue of affordable health care
coverage just below our economic recovery, the war in Iraq and terrorism,
Americans appear to be united in their apprehension that, if left unchecked, the
current upward spiral of health care costs may leave the American workforce
paying more toward their families’ health care coverage than they can
reasonably afford – or possibly leave them without any coverage at all. If the
focus on consumer-driven health care coverage remains as high on the Bush
Administration’s agenda during the President’s second term as it was during
his campaign, then millions of Americans may expect to assume greater
responsibility for their own and their families’ health care – both in terms
of decision-making and in terms of cost-sharing. However, employer-provided
health insurance – perceived by the majority of American workers as the most
important employee benefit a company can offer (as reported in the 2004 Health
Confidence Survey published by the Employee Benefits Research Institute (EBRI)
– is not likely to be eliminated, replaced or significantly reconfigured at
any time in the foreseeable future.
 Along with the EBRI survey, a number of other recent studies
conducted by various non-profit research organizations (including the Kaiser
Family Foundation, the Employment Policy Foundation and the Institute for the
Future) suggest that, although health care costs are expected to continue to
rise during 2005 and well into the next decade, an integrated effort on the part
of health care consumers, providers, insurers and legislators to control
expenses may also result in American families and employers achieving more
control over how their health care dollars are spent and the quality of care
that is received. For example, the trend toward managed care that began in the
1980s has fostered the concept of "disease management" as a method of
controlling expenses while improving the health outcomes of patients suffering
from certain common and costly chronic diseases.
Another area in which costs may be better controlled while
the quality of care improves is prescription drug utilization. As the
pharmaceutical industry produces more diverse and effective products that will
save more lives and improve the quality of the lives they may prolong, a two- or
three-tiered approach to prescription drug benefit levels – along with higher
co-payments – are likely to be implemented by many more employer-sponsored
plans in the near future.
While employer-provided health care plans are certain to follow national
trends toward increased cost containment and cost-sharing during the coming
year, more and more large companies are expected to take the lead in offering
their employees a wider range of consumer-directed health plan options. These
may include plans with higher deductibles, as well as "defined
contribution" health care plans which would give employees greater control
over how employer contributions are used than had been the case with traditional
health care benefit plans. It is anticipated that the lower costs and greater
flexibility (particularly in employer contribution levels) associated with
consumer-directed health plans might also make them attractive to small
businesses that otherwise might not have been able to offer their employees any
coverage at all.
Consumer-directed health plans and other methods of coping
with skyrocketing costs will require American health care consumers to become
better informed, more actively involved, more conscientious about healthy
lifestyles and behaviors, and more proactive in the selection and purchase of
health care services, products and supplies.
As health care expenditures have come to represent an increasingly larger
portion of our Gross Domestic Product and health care cost increases have far
outpaced the rate of inflation, EBRI reports that three-quarters of working
Americans would rather receive an increase in employer-provided health insurance
than an equivalent increase in pay. For 2005 and in the years to follow, the
value of employer-provided health insurance coverage will be measured not only
in terms of a company’s benefit program, but also in terms of a company’s
ability to attract and retain a healthy and productive employee population. |
