BlueCross BlueShield of North Carolina produced the following infographic about the high cost of health care, and I added the following comment.
The key to getting costs under control is to get the incentives right all along the health care continuum.
PAYERS — Where insurance companies once were able to control profits by selecting only the healthiest customers and cutting off those who became too expensive, that’s no longer the case under Obamacare, so they’re finding new ways to stay profitable, including extending wellness programs, which were initially developed for self-insured corporations, to their other customers. They’re also offering deep discounts on premiums to customers willing to accept higher deductibles and copays, giving them more skin in the game. Some are even starting to pay for medical tourism and home health care with telehealth video consultations and the necessary medical devices and home modifications when the costs are less and outcomes better. That’s promising.
CONSUMERS — With good insurance, consumers have had little incentive to seek the best value in their health care or lifestyle choices because, after all, someone else was paying, and they often didn’t even see the costs anyway. While high-deductible policies have given them new incentives to shop around, they are increasingly able to actually do that, because insurers are pressuring providers to be more transparent in their pricing up front. Those without insurance often avoided preventative care, would let their medical conditions fester until they required emergency care, or would rely on the much more expensive ER rather than a family physician. Obama is addressing this too, and I also find that encouraging.
PROVIDERS — The medical industrial complex has been immensely profitable by viewing patients as paying customers and working to keep them … paying … by treating symptoms and managing disease. There has been no profit incentive to promote health, wellness, and prevention and, in fact, medical schools don’t even teach that. There’s so much resistance to change that this industry spends twice as much on lobbying as the military industrial complex, because it doesn’t want real health reforms that would lessen their $2.8 trillion in revenue. That lobbying is at the root of opposition to Obamacare. That’s troubling.
POLITICIANS — With their primary objective of getting reelected, and the influencing power of wealthy special interests, it’s no wonder that corruption runs rampant. Policy decisions are made along ideological lines and catering to those special interest rather than the overall public good. Policies that harm the environment and the food supply or that widen the wealth gap actually contribute to increased demand for medical care rather than lessen it. That’s just stupid.