Reform by Any Other Name
Healthcare Reform Panel
Prescription for Change
Not a Bitter Pill
Cut Out the Middle Man
MODERATOR: We have talked a little bit about HSA plans and engaging people—sharing cost information in order to help them make decisions. What happens when you are through the deductible or hit your maximum out-of-pocket? Are people still cost conscious because they are looking at this money as their own?
SABATINO: We are about 12 years out since these plans were originally introduced by very large organizations, and there’s a lot of evolution around plan designs that will mitigate some of that demand. So we are seeing trends that say bigger deductibles, funds that are meaningful, but where there is clearly an objective that there be enough of a gap between the fund and the health plan.
One hundred percent co-insurance plans really do not support consumerism. So if you were going to build the perfect world, you would want some kind of skin in the game. Eventually if you get into a catastrophic situation, you may start to see behaviors kind of slip back. But that’s why there is a real need for this to be more of a cultural shift—certainly from an employer standpoint, but overall from a country perspective—that individuals understand that this isn’t free, any of this. Someone is picking up the bulk somewhere. Ultimately, we need to create an environment where good decisions are rewarded, where health is rewarded, and where organizations look at health as a brand.