From the people
who brought you Part D…
President to push ‘market-driven’ health care
proposals
Newswise — University of Michigan researchers who have
studied the impact of out-of-pocket health costs on
Americans’ behavior are available to comment on new
‘consumer-driven health care’ proposals that President
George W. Bush is expected to unveil in his State of the
Union address on Tuesday evening.
While the details of
those plans are not known, they are expected to involve
more emphasis on individual cash accounts and cash
expenditures for health care, in exchange for tax breaks
or other incentives.
If so, the researchers
say, any plan to increase the consumer’s role in health
spending must also include a way to ensure that
consumers get essential, proven preventive care for
little or no money of their own.
These include
medications and tests that have been proven to save
money in the long run, by preventing the progression of
problems or spotting them early. They include screening
high-risk individuals for cancer, cholesterol-lowering
drugs for people who have survived a heart attack,
vaccines for children, and certain medicines and tests
for people with diabetes mellitus.
Research at U-M and
elsewhere has shown that the more money people have to
pay out of their own pockets to get such care, the less
likely they are to actually take the medicines or have
the tests done. And that increases the risk of more
expensive — and preventable — problems down the road.
“Involving consumers
in making their own health care spending decisions is
important and will likely save money at least in the
short term,” says A. Mark Fendrick, M.D., co-director of
the U-M’s Center for Value Based Insurance Design and a
professor in the U-M Medical School and U-M School of
Public Health. “But most of the discussion regarding
consumer-directed health plans fails to address the fact
that increasing out-of-pocket expenditures will lead to
decreased utilization of essential health care services.
We need to create a system that will remove financial
barriers for those clinical services where there is
clear evidence of value.”
Fendrick, along with
fellow researchers Michael Chernew, Ph.D., John Piette,
Ph.D., and Allison Rosen, M.D., MPH, Sc.D., of the U-M
Medical School and U-M School of Public Health have all
studied how people change their medicine-taking habits
and other health behaviors depending on how much cash
they have to pay.