Conventional wisdom, at least among employers and their consultants and some health care policy gurus, says one reason for high health care costs is that you don’t care about those costs and that because you are mostly insulated from costs, you use health care with impunity. In other words, you go to the doctor too often and when unnecessary, you take too many prescription drugs, you have too many tests and you have no incentive to question the cost of care or the amount and type of care you receive.
You already know the consequences of all this; higher deductibles, higher co-insurance, increased use of pre-authorization and concurrent utilization review and smaller networks with higher financial penalties if you do not use participating providers.
Now the question is are they right?
If you have a high deductible health plan, your family deductible may be several thousand dollars. This means you pay for virtually all your families out-patient care in a year. That’s all the visits to the pediatrician, perhaps a visit to the emergency room and even an MRI or two. Knowing this, will you change your behavior?
Claims of lower costs as a result of these higher levels of cost sharing are valid and obvious. If your health plan is no longer paying for the first $4,000 of your expenses, the plan saves money, but if that simply means that you are now paying those costs, not much has been accomplished.
So, are you ready to be a consumer as well as patient? Will you question prices in advance? Will you ask more about the treatment being suggested? Will you seek lower cost health care providers if you are paying 100% of the bill?
A lot is riding on you changing your behavior. Are you up to the challenge?
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