Do HDHP's cause people to learn about health care?

The June 13 Wall Street Journal contained an article on the growing influence of patient groups on medical research. The article states,

“Online patient groups have become an increasingly powerful force for health-care consumers over the past decade, raising funds for research and offering patient information and support. Now, as the cumulative power of their memberships grows, these groups are becoming invaluable partners to researchers and physicians searching for cures.”

This reminds me that the debate about high-deductible health plans may be missing an important point: HDHP’s are not the fundamental motive for patients to become increasingly informed about health issues, and are not the reason patients are trying to be “better shoppers” for health care. Instead, those developments were happening already - and independently. Access to health care information via the internet was around long before so-called “consumer-directed” health plans tiptoed onto the stage.

Viewed in this light, the true significance of the high-deductible plans may be that,

· AFTER consumers have influenced their health care treatment for the better

· based on more-informed discussion with their physician,

· the patient may realize some financial benefit, in some circumstances,

· from the health care choice they influenced

· because HDHP’s remove the insulation from costs that too many insurance plans provide.

But I do not believe that HDHP’s are driving some fresh new search by patients toward more health care knowledge. That search was already well under way; the key enabler is the internet; and as more and more people access the internet, the search for health indformation will continue to broaden and deepen.

Can the general public handle this new knowledge?

I think so. No one expects patients to become the equivalents of physicians, even tho some, as reported in the Journal article, will become very sophisticated. The general expectation is only to become aware of alternatives, possibilities, and relative costs (including approximate out-of-pocket costs).

The U.S. Census Bureau has estimated that, in 2007, a total of almost 21 million Americans cannot read a newspaper; cannot add, subtract, or balance a checkbook; cannot write a complete sentence; cannot speak - or can barely speak; do not vote; and are incapable of self-support. [Table 094 Midyear Population by Age and Sex.]

I’m referring to the population age 4 and below. Does the present ignorance of this population mean that we should expect these individuals can never learn how to be functioning members of our complex, modern society? Is it preferable to keep this population ignorant because someone might argue that learning is beyond their grasp?

I think the answer is self-evident: of course we can educate our children. Of course learning is not beyond their grasp. And of course we can expect our children to mature into self-sufficient adults.

In a similar fashion, I think it is a mistake to believe that the general adult public is incapable of absorbing increasingly sophisticated information in regard to their own health and health care.

The trend toward increasing general knowldege of health care is continuing - and IMO cannot be stopped. The so-called “consumer-directed” health plans simply provide a means and a financial incentive for knowledgeable individuals to pursue superior and in some cases lower-cost health care alternatives. We need not worry obsessively today about the growth of these plans. They will grow in proportion to the expanding health care knowledge of the population.

ADDENDUM: For a fascinating, real-time example of almost exactly the kind of issues Mike mentions, be sure to check out this post at Dr Wes' blog, and especially the comments section. HGS