As Massachusetts Universal Healthcare Plan Struggles, Debate Over Consumer-Driven Healthcare Heats Up

This morning, the Boston Globe reported on Massachusetts’ ongoing struggles to pay for its ambitious universal healthcare plan.  The state has considered shifting additional costs for the program onto businesses, but has come up against resistance.  In response, employers and insurers formed a new lobbying group, the Coalition for Affordable Health Care.  According to the Globe:

“The [group] said it will fight efforts to increase assessments on employers who do not provide health coverage for workers. It will also oppose raising the standards for what constitutes a ‘reasonable’ contribution under the state's healthcare overhaul law, a groundbreaking effort to extend health coverage to all Massachusetts residents.”

At a meeting in Boston, there was discussion about how the state could best control spending.  Charles Baker, CEO of Harvard Pilgrim Health Care, said that higher spending does not result in better outcomes.  He advocates for consumer-driven healthcare as a means of reducing unnecessary and expensive care.

However, opponents think Baker’s solution is inappropriate.  Amy Lischko of Tufts University said that “consumers don’t act like rational economists” and won’t “change the doctor they’ve been seeing for 10 years because a visit is going to cost $10 more.”

The debate currently taking place in Massachusetts is very interesting.  First, it showcases some of the difficulties in improving access to quality care at a reasonable cost.  Second, there seems to be a misunderstanding about what consumer-driven plans are all about.  In my mind, it’s not just about getting people to use fewer services, but encouraging people to become active managers of their own care.

Unfortunately, this is a very difficult task.  For example, according to a recent California Healthcare Foundation study, many are using the Internet to find information about their health conditions.  However, very few are taking advantage of online resources to manage their health.   According to the Foundation, only 29% of Californians aged 18 – 39 use it to research health provider rankings.  Moreover, very few actually switched medical professionals because of what thy learned. 

The debate over consumer-driven healthcare will surely continue.  No matter how it evolves it’s very clear that we have to find better ways to encourage people to become more active stewards of their own care.