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Fixin' Healthcare

Monday, February 06, 2006

The Lifestyle Chronicles - Who Pays?

Health insurance is a complicated issue with many facets. The State of the Union address proposed more emphasis on tax deductable health savings accounts (HSAs). Presumably this would put choice and decision making with the consumer who would make better decisions because of the financial risk/reward (consumer driven health care).

I came across this report from researchers at the University of Michigan who have studied the impact of out-of-pocket health costs on American behavior. They advocated that any plan to increase consumers' role in health spending must include provision to get proven preventive care for little or no money of their own. Research shows the more people have to pay out of their pockets for prevention the less likely they are to do it. HSAs would be considered out-of-pocket.

How people view risk and the desire for security are at the core of the health care crisis. There is a strong tendency to overrate risk with severe consequences even though the incidence is low. And, people truly do not fully understand the influence of daily activities on health status. The portion of the personal budget that has the greatest influence upon future health status is not considered by people as health care. It is food, housing, transportation, education, recreation, etc. And, these are dollars that are going to be spend in any case whether there is a health benefit or not.

Preventive maintainence perhaps similar to the airline industry or personal warrenty cards would not be inappropriate concepts. Primary health care should focus upon this area with emphasis upon health risk assessment and risk management. There might be need (opportunity) to develop and train health coaches who could work in primary health care practices and industry and schools.


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