Opinion
Consumer-directed health care just the latest risk-shifting scheme
LETTER — Posted Feb. 18, 2008
Regarding "Culture shock: Consumer-directed health care slow to catch on" (Article, Dec. 24/31, 2007): Consumer driven health care is nothing more than risk shifting from insurer to patient.
All insurance is about the assumption of risk, and health insurance is no different.
Despite all its lofty rhetoric about improving quality, managed care has always been about risk shifting -- first from HMO to business (that failed), then from HMO to doctor groups/IPAs (that failed with spectacular bankruptcies minutely chronicled in these pages), and now to the last victim -- the patient.
As the United States heads into a recession, this last futile act of risk shifting will also surely fail. CDHPs, as you term them, are just another gimmick by the insurance industry to lure doctors and patients into magically thinking that they can get something good for nothing.
Your graphic nicely shows progressive risk shifting in the form of higher deductibles from 2002 to 2005. It's unlikely that the financially strapped consumer will be any healthier or financially better off with more risk for health care costs. And as for patients with high deductibles (read risk) having much bargaining power with high-quality providers like the Mayo Clinic or the Cleveland Clinic, good luck.
Brant S. Mittler, MD, San Antonio
Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/02/18/edlt0218.htm.
