Late last year, the Guardian Life Insurance company surveyed 1,000 working folks, specifically looking for their attitudes and opinions about Consumer Driven Health Care. Not surprisingly, the survey found that there's a lot of misinformation about CDHP, and that if we're going to have a meaningful national debate about its role, we need to clear those up.
While "traditional" plans still hold the lion's share of the market, consumer driven products (e.g. HSA's, HRA's, etc) are gaining ground, with some 14% of the market. Still, given that the current version of HSA's has been around for almost half a decade, I found that result disappointing (although not, frankly, surprising). The survey focused on the group market, though, so these numbers may or may not translate to the individual.
Part of the problem with that anemic enrollment is that almost half the respondents (44%) believe that such plans are actually more expensive than PPO's or similar plans, and almost a third (29%) are very concerned about what would happen if there was a catastrophic claim. There are two problems with this, of course:
First, high deductible plans are almost always going to have lower premiums than comparable co-pay plans. This just makes sense: if the carrier is off the risk for the little claims, they can charge less premium. The second problem is that, come a major claim, the high deductible plan will have - at worst - no greater out-of-pocket exposure than the co-pay plan, and often a lower one.
Another interesting find is that " (a) strong majority of consumers (85%) want more control over decisions that affect their health care, and 81% think health care costs should be transparent. Nevertheless, 33% of workers feel overwhelmed by too much information already."
That's really a shame. On the one hand, it illustrates that people do want to have some say in their own care, and a majority (think they) want more transparency in that care. On the other hand, there are still a lot of folks who are saying "TMI!" Still, they represent a minority opinion, and can easily avoid that overload (just swear off WebMD and Google).
Having done a number of employee enrollment meetings over the years, I wasn't the least bit surprised by the finding that over half (53%) of those surveyed listed co-payments for doc and hospital visits, not price, as their number one concern. That's not news to me (nor, I suspect, my colleagues): after carefully explaining how the high deductible plan and accompanying savings account work, the number one question I'm asked is always "okay, Mr Stern, that's really great. But what's my co-pay?" After explaining again how the plan works, and that there are no co-pays, the second question I'm asked is always "oh, that makes sense. So, then, what's my co-pay?"
I'm not trying to make fun of the employees here - after all, we're the ones who've been pushing $10 and $15 co-pays for years - but to illustrate the uphill battle we face if we're going to break through that 14% barrier. In the event, the complete results are here, and I'd recommend reading through it for even more insights.
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