Patient Power Vindicated
The RAND study examined the impact of high-deductible and consumer-directed health plans on families living in low-income areas where median income is below 200 percent of the federal poverty level. Also examined were families with a member who had one of the five most costly chronic physical illnesses — heart disease, cancer, diabetes, high blood pressure or kidney disease. Medical spending declined among all families enrolled in high-deductible and consumer-directed health plans, relative to similar families in traditional plans, with the reductions among medically vulnerable families generally being similar to that seen among other families, according to researchers.
Read full article on high-deductible health plans.
This is good news after an earlier RAND study found people enrolled in high-deductible plans consumed moderately lower amounts of preventive care.
Something public health advocates are loath to understand (or accept) is that attitudes and preferences about medical care vary from person to person. Demand for medical services varies from person to person even when holding health status constant. Health inputs vary; healthy behaviors also vary from person to person. As a result, health outcomes vary. When health outcomes differ slightly by race, gender or income, it is automatically assumed to be a failure of the health care system rather than the result of culture, lifestyle, priorities or preferences. The problem is: culture, lifestyle, priorities or preferences are difficult to change quickly.
So glad to have yet another study that concludes that people are more careful spending their own money than someone else’s even when buying health care, that super-special not-like-any-other-good good.
Now, if the authors are really interested in whether poor people act the same way as people with private insurance, they might take a look at the Medicaid consumer directed pilot programs.
They’d better not wait another couple of decades, though, federal and state bureaucracies are busy loading on the regulation. These successful programs will rapidly fade from view.
Thanks for posting this. This is very interesting.
Linda, this study may be discovering the obvious but it’s still nice to have RAND’s name on the finding. It helps silence the critics.
I agree with Joe.