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CONSUMER
CHOICE MATTERS, #1
DATE:
January 31, 2003
TO:
Consumer Choice Matters Readers
FROM:
Greg Scandlen
This
week I want to introduce you to a new
weekly publication of the Galen
Institute called Consumer Choice
Matters. It will be issued every
Tuesday. This will be the flagship
publication of Galen's new Center for
Consumer Driven Health Care and
dedicated to new developments around the
country in the movement for increased
consumerism in health care.
There
is so much going on in this area that
writing it up in a linear fashion is
almost impossible. It's like trying to
describe a river. Do you start with the
rapids, the eddies, the banks, or the
islands? What is most important - how
long, how wide, or how deep it is? The
muddy water that has just passed by, or
the fresh water yet to come?
The
movement towards consumer driven health
care is every bit as complex and fast
moving as a river. My colleague Joe
Moser and I are trying to develop a list
of the companies involved in this
movement, but how should we classify
them? There are patient education
programs, insurance products, third
party administrators, software
companies, debit card companies, banks
and mutual funds, physician networks,
quality assessment efforts, e-management
firms, brokers, advisors, consultants,
and venture capital companies. Some
firms have already come and gone, others
are just starting up, and others have
completely revamped their original
concept.
Of
course there are other important
players, too - employers, regulators,
legislators, physicians, hospitals,
nurses, economists, and most important
of all, individual consumers of health
care services.
The
river of consumer driven health care is
sweeping up all of these players. After
fifty years of ever-greater reliance on
third parties to make decisions for
individual consumers, the tide has
changed. Virtually no one thinks the
United States, or any other developed
country, can continue to treat
individuals as passive recipients of
services granted by paternalistic
bureaucracies.
The
American people are increasingly
well-educated and self-confident in
making their own decisions about what is
best for their families. Company health
plans will soon become as anachronistic
as company cars, company housing, or
company towns. We no longer look to our
employers to provide us with a home or a
car. We expect to be paid good wages for
good work, and we will decide how best
to spend our own hard-earned money.
Recently
many of us have discovered that we can't
always trust our employers for guidance
on how to invest our 401(k) funds. What
is best for management isn't always best
for the rest of us.
The
same is true for health care. The
industrial age is behind us. There is no
guaranteed employment. We change jobs
every few years. In the information age
we need to make our own health care
decisions. We need to control our own
health care resources. We need to own
our own insurance policies.
It
isn't that employers have done a poor
job. They didn't ask for the
responsibility of running a health plan.
It was thrust on them the same way it
was thrust on us. They've done the best
job they could for a very long time.
But
imagine if you were told that from now
on you would have to manage your
neighbor's health care. You would have
to make all his decisions. You would
have to decide how much money to spend
on him. You would decide what doctor he
could see. How would he feel about you?
How would you feel about him?
It
would be an impossible situation - one
that would create tension and hostility
where there shouldn't be any. And the
situation would be no better if the
responsibility were given to a
government employee instead.
But
moving a $1.3 trillion industry from
reliance on third-party paternalism to
consumer empowerment is no easy job. It
will take many years to get there.
We
have already taken the first few steps
with the enactment of medical savings
accounts, the establishment of health
reimbursement arrangements, the creation
of Internet enrollment and patient
education, and the beginnings of defined
contribution approaches to health plan
purchasing.
Not
everything we try will work. There will
be errors and missteps, corrections and
revisions. There will also be hopeful
signs and success stories.
Galen's
Center for Consumer Driven Health Care
will monitor all of this, and report on
it every week in this Memo. We will try
to provide an honest evaluation of the
good and the bad, not just be
cheerleaders for every screwball idea
that comes along. We will review news
reports, research papers, press releases
and testimony and provide you with
source material, including hard links
whenever possible.
The
Center will also work on educating
decision-makers - employers,
politicians, physicians, insurers and
consumers - on what works and what
doesn't. We expect to be giving speeches
and appearing in the media all over the
country, publishing research reports,
testimony, and op-eds.
We
don't have a monopoly on good ideas, and
we hope you will become an active
participant in the process. We hope to
make our work as interactive as
possible, so we can all learn from each
other as we go along.
Rafting
down a river isn't for the timid. There
are rocks and shallows and rapids around
the bends. But we are glad to have you
on board.
Greg
Scandlen
Director
Center for Consumer Driven Health Care
The Galen
Institute
P.O. Box 19080
Alexandria, VA 22320
703-299-9206 (office)
301-606-7364 (cell)
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