THURSDAY, Dec. 8, 2005 (HealthDay News) -- Americans enrolled in new consumer-directed health plans are less satisfied with these plans than people who retain conventional comprehensive coverage, a new survey found.
Such findings raise concerns that the plans are causing people to forego needed care as they force more out-of-pocket costs for patients, according to the survey authors.
"Among adults who have the consumer-driven health plans, we are finding lower satisfaction with quality of care, out-of-pocket costs and a low satisfaction in their plans overall," said Sara Collins, the report's co-author and senior program officer of the Commonwealth Fund's Program on the Future of Health Insurance.
"Few people in these plans would recommend them to friends or co-workers," Collins added. "By focusing exclusively on the demand side, incentives give disproportionate responsibility on cost control to people with health problems or lower incomes."
Collins spoke at a news conference Thursday as the results of the survey, "Consumerism in Health Care Survey," were unveiled. The survey was conducted by the nonprofit Commonwealth Fund and the Employee Benefits Research Institute and was funded by the Commonwealth Fund, with additional support from IBM Corp., Pfizer Inc., and Procter & Gamble.
Overall premiums for health insurance have increased significantly in the last five years, far outpacing gains in worker income.
"The average premium for health insurance exceeds the annual income of a minimum wage worker," said Karen Davis, president of the Commonwealth Fund. It's not surprising, then, that the number of uninsured in the United States increased from 40 million in 2000 to 46 million today.
In their search for lower cost health insurance, some employers have started adopting consumer-driven health plans, namely high-deductible health plans (HDHPs), often in tandem with health savings accounts (HSAs). People can make pre-tax contributions to HSAs as a way to build up a nest egg for future medical expenses. Consumer-directed health plans, in general, are intended to foster cost-consciousness among health-system users.
"HDHPs with or without HSAs are being designed to try and control health-care costs from the demand side and they are really quite controversial at this point," Davis said.
"Proponents believe they will encourage individuals to become astute health-care consumers making decisions about health care on the basis of cost and quality, and in that way contribute to a slowdown in health-care costs," Davis added. "Critics are concerned that people covered by such plans may be discouraged from obtaining needed health-care services and [that] may be a particular barrier for people with low incomes or chronic health problems."
This Internet-based survey of 1,204 U.S. residents aged 21 to 64 was conducted in September and October. All participants had to have private insurance, and a high deductible was defined as $1,000 per individual and $2,000 per family.
About 1 percent of respondents were enrolled in a consumer-directed health plan, and another 9 percent in an HDHP without an associated HSA.
Among the survey's other findings:
The survey results are in contrast to a Blue Cross/Blue Shield survey released in September that found that HSA enrollees expressed greater satisfaction than non-consumer-directed health plan enrollees in overall satisfaction with their plan, responsiveness of customer service, information provided on health-care benefits and access to preventive care and wellness services.
The survey was criticized by proponents of consumer-driven plans.
"If someone is going to get free health insurance, they would rather have it be comprehensive than have a cost-sharing provision. But the reality is you don't get free health insurance," said Greg Scandlen, founder of Consumers for Health Care Choices, in Hagerstown, Md. "You're required to pay or your employer is required to pay and reduce your wages."
More information
Find more on the report at the Commonwealth Fund.