Today's Health Care Consumer Essay

1460 Words 6 Pages
There are two types of consumers; the informed and the uninformed. The patient, i.e. the consumer, is typically unaware of the total cost of health services provided to them. They may have a copay or deductible, but the explanation of benefits and outline of care comes after treatment has been rendered. This approach has made it difficult for patients to be able to “shop around” for the best prices when in most cases they are not sure what the cost treatment will be. They were, by no fault of their own, uninformed consumers due to plan designs.
The plan design of the health maintenance organization (HMO) for example, “masks the true cost of care” because the consumer only pays the copay (Kongstvedt, 2007, p.474). The copay is only a part
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A different approach adopted by some health insurance companies is scheduled benefit plans. These types of plans provide the consumer with the cost of the service prior to being provided. The downside of this approach is that the consumer is still unaware what portion will be covered by insurance thus they are unable to plan appropriately since they only have one half of the equation (Kongstvedt, 2007, p.476). Consumers are demanding transparency from their health insurance carriers. Munn (2010) states “consumer-driven” plans are beginning to evolve into “consumer-focused” plans. The plan designs nowadays give more information and also offer incentives to their consumers as a way to aid in decision making (Munn, 2007, p.45).
Coverage of preventive and routine care services is used by health insurance companies as incentives for consumers to enroll into their plans. Consumers typically do not want to pay out-of-pocket for preventive or routines services. The importance of these services can be seen as employers are becoming more focused on preventive or health improvement options for their employees (Munn, 2007, p.45). Discounts are given to employees who maintain healthy behaviors while unhealthy behaviors such as smoking will result in a higher health insurance premium for an employee. Consumer involvement in health insurance coverage has increased resulting in an increase in the interaction between the consumer and health care
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