Consumer and Provider Costs

There are two sides to every story. Healthcare policy, like most other state or federal policy, is often fiercely debated by people with different beliefs, but in the end the ultimate goal is usually agreed upon by all. What is actually being debated is the best way to arrive at the desired destination. Specific to healthcare, most involved in policy making agree that the coveted outcome is to be able to provide the best quality health care to as many people as possible while keeping costs under control and limiting healthcare spending. Usually, there are pros and cons to each side’s approach.

           The debate on consumer cost in healthcare today is a perfect example of this. The conversation revolves around the idea of returning more of the cost burden of healthcare to the patient by increasing their out of pocket costs. This can be accomplished by the employer sharing more of the cost of the premium payment with the employee (Kosteas, 2014), or by the insurance company increasing personal or family deductibles. In both instances create an environment where many believe the patient is forced to become more economically invested in their medical care. On one hand, the insurance company, who would benefit from this plan by having to cover less of the healthcare costs, benefits financially. On the other hand, the consumer (patient) now has an increased financial burden when they are already paying for their healthcare. Insurance companies justify this action by making the argument that by returning more the cost burden to the patient, as a consumer, the patient will make more responsible healthcare spending decisions (Geyman, 2012). On the other hand, one could argue that putting more of the cost burden on the patient could potentially lead to an unhealthier society. This can occur in many ways. First, patients who can not afford an increased out of pocket deductible may chose to begin to not seek necessary healthcare when they otherwise would have in order to avoid receiving extra bills. In instances where a patient does take the first step of seeking a physician’s advice for an ailment, they may choose not to proceed with treatment for the same reason (Thomson, 2013). In addition to these ideas, the concept of forcing the patient to become a smarter consumer by returning cost burden to them is flawed. In healthcare, although informed and educated patients have a role in the decision-making process in their healthcare, the decisions to order expensive tests, medications or surgeries are made by the physicians. With that being the case, the patient consumer does not have the opportunity to become significantly more cost conscious with regard to their healthcare, and in all honesty, it is not a position that most people should be put in, to decide between their healthcare and their finances. 

References:

1)   Kosteas, Vasilios D., & Renna, F. (2014). Plan choice, health insurance cost and premium sharing. Journal of Health Economics, 35, 179-188.

2)   Geyman, J. P. (2012, September). Cost-Sharing under Consumer-Driven Health Care Will Not Reform U.S. Health Care. The Journal of Law, medicine and ethics, 40(3), 574-581.

3)   Thomson, S., Schang, L., & Chernew, M. E. (2013). Value-based cost sharing in the united states and elsewhere can increase patients' use of high-value goods and services. Health Affairs, 32(4), 704-12. Retrieved from https://search-proquest-com.contentproxy.phoenix.edu/docview/1337184869?accountid=134061