Toward Free Market Health Care

For most employers, regardless of size, shape, or industry, the days of sheltering employees from soaring health care costs are long gone. Even the country’s larger employers—those most capable of de-pressurizing inflating premiums with high health-plan enrollments—have shown an increased willingness to transfer health care expenditures to those they employ. Consider the findings of a 2007 survey conducted by human-resources consulting firm Watson Wyatt Worldwide and the National Business Group on Health, which revealed that nearly 40 percent of large companies now offer consumer-directed health plans (CDHP), up from just 2 percent in 2002. 


Though enrollment in consumer directed plans—typically characterized by high deductibles coupled with a health savings account (HSA) or health reimbursement account (HRA)—remains modest, a growing number of working Americans are shouldering greater responsibility for their health care spending. And their ranks will only continue to swell. As a result, employees have begun to make the transition from being passive recipients of health care to active health care consumers.
“In some ways, people who have been patients in a traditional health care system . . . that relationship is typically characterized by kind of low expectations on the part of the patient,” says Mary Brainerd, CEO of Bloomington-based HealthPartners. “You walk into a room and wait for someone to do something to you, and you typically don’t even know what that something will be.” Or what the final tab for that something will amount to when the bill arrives. 


Now that greater portions of health care tabs are covered by out-of-pocket funds, however, consumers are becoming more engaged in their health care purchases. That’s why health plans and providers have begun to adopt more consumer-friendly personas and practices. “Some providers are behaving a bit differently as they start to prepare themselves for the retail market,” notes Tina Frontera, senior director of transparency and tiered networks, for Minnetonka-based Medica. “If you go to a provider’s Web site, for example, you’ll likely notice that they look a bit different than they did a few years ago in that they’re attempting to appeal more to the consumer, not necessarily to the patient.” 


The buzzword most commonly associated with this medical-marketplace shift is transparency, a term broadly used to describe the ways in which health plans and providers make cost and quality information readily available to consumers. To Brainerd, it means providing access to “the information consumers need to make good health care choices.”