Consumer reaction against managed care appears to be easing up, according to a recently released national survey that says that not only are patients willing to accept more restrictive health plans, but they understand why such measures are necessary. The California HealthCare Foundation says that in order to control rising costs, 54 percent of respondents would accept using less expensive drugs, 52 percent favor having to go through a gatekeeper to see specialists, and 43 percent would accept prior approval for new and/or expensive treatments. These were all features of managed care that, until recently, were reasons patients cited for being dissatisfied with the system.
"The managed care backlash is easing up, probably because consumers are feeling the pinch of rising costs themselves," says Claudia Schur, principal research scientist at the National Opinion Research Center at the University of Chicago, which conducted the study for the CHCF. "However, support for managed care practices is quite segmented, depending on each consumer's health care experience and needs. As a result, we may see more plan offerings where consumers who want choice can pay for it, while those willing to accept limits on their care can pay less."
The survey was conducted by phone in August and includes responses from more than 2,000 adults nationwide. The findings show that the trade-offs that someone will accept between keeping costs down and having more restrictive benefits depend on where that person fits in the socioeconomic order.
"Wealthier consumers in bad health were most resistant to restrictions on their care, while low-income people in bad health were much more likely to accept such restrictions, presumably because of their limited ability to pay," says the CHCF.
Younger and healthier people — those who have grown up with managed care — were more willing to accept common cost containment practices such as specialist referral.
Meanwhile, a survey by the Blue Cross and Blue Shield Association finds that health care should be one of the top items on the new Congress's domestic policy list. A poll of 1,000 people conducted Nov. 4, 6, and 7 finds that 40 percent of consumers see health care and prescription drug costs as two issues that should be top priorities for lawmakers.
BCBSA President and CEO Scott P. Serota believes that putting the focus on quality may be the way to help rein in costs and create a better health care system.