MANAGED CARE November 2005. ©MediMedia USA
The turbocharged rush to offer choice to consumers leaves a question in its wake: Choice of what? It turns out that consumers value having a choice in providers more than having a choice of health plans, according to a study by the Commonwealth
Fund, which warns that "policymakers should be cautious about embracing the individual market and health savings accounts as a way to improve satisfaction in the system."
Furthermore, the survey of 3,293 adults ages 19 to 64 found that "respondents expressed confidence in employers' role in selecting health plans — even when they were not enrolled in an employer-sponsored plan — and two of three adults preferred an employer-selected set of health plans to an employer-funded account to be used for purchasing health insurance in the individual market."
OK. Let's take a deep breath. What the Commonwealth Fund survey seems to suggest is that there is no groundswell of consumer demand for consumer-directed health care. It certainly seems to shine a skeptical light on the phrase "consumer-driven health care" that those who want to see this change often use. Consumers aren't driving this shift. They, for the most part, like things just as they are, according to the Commonwealth Fund survey. "...[T]he type of choice that people most desire — where to go for care — may not be met by policies that promote a shift from employer-based coverage to individual market insurance."
"This all suggests that satisfaction with care is more closely associated with the ability to choose providers than the ability to choose health plans," says the survey, titled "'Choice' in Health Care: What Do People Really Want?"