Employee Benefit News

April 20, 2006

Experts debate effectiveness of consumerism

President Bush and administration officials promoted health care
consumerism and expanded HSAs, but other politicians criticized
that approach at the World Health Care Congress in Washington,
D.C. yesterday.

"America's health system should be run by doctors, patients and
consumers," Bush said in a taped statement. "HSA owners make
their own decisions about health care spending, and that gives them
an incentive to get a better value for their dollar."

U.S. Rep. Pete Stark (D-Calif.) disagreed: "I don't have much faith in
HSAs doing anything more than shifting costs to the poor and
shifting costs to the sickest among us."

In emergencies, "you don't have time to ask the ambulance driver
where you are going, much less how much it will cost when you get
there," he noted. "When you're talking about choice, you're not talking
about the full population." He cited food poisoning, fractures, allergic
reactions, strokes and heart attacks as events where choice is
impossible.

Allan Hubbard, a Bush aide on economic policy, admitted
consumerism doesn't work in those situations, but downplayed that
scenario. "You can only shop in a non-emergency. Emergencies
represent a relatively small percentage of the cost of health care," he
asserted.

Part of the debate focused on transparency of price and quality
information. Hubbard warned that Congress will force doctors and
hospitals to reveal this information if they don't do so voluntarily.

Bush said, "Americans need to be informed consumers, yet far too
much information about price and quality is hidden from patients."
However, two doctors in the audience argued that such information
in the public's hands causes misunderstandings. Quality is
complicated to define and difficult to understand, given the wide
disparities in patient demographics and severity of disease, they
noted.