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As employers move to so-called defined-contribution health care plans -- which provide a set amount each year from which employees must pay for all treatments except those for catastrophic illnesses -- chances are good that unhappiness at work will rise.
That's one conclusion to be drawn from the answers of the 600-plus people who responded to our May 9 Reader Survey.
For example, nearly 52% of the respondents to this unscientific survey said they oppose defined-contribution plans, vs. the 38% who say they favor them. Some 57% of those who replied said that defined-contribution health plans would prompt them to use cheaper generic drugs, while 38% said they wouldn't.
When it comes to choosing doctors and hospitals, however, the people who replied to our survey seemed to challenge the assumption of some health-care consultants that if patients have to spend more of their own money, they'll choose lower-cost care.
For instance, 77% of those who replied said they wouldn't be more likely, with such plans, to use the lowest-price physician, while 73% said they wouldn't choose the lowest-price hospital. Some 57% said they wouldn't shop on cost alone because of concerns that their quality of care would fall, while 26% said they would simply prefer to stick with their current health-care providers.
Incidentally, some 51% of those who responded fear that the quality of health care will decline under a defined-contribution system, while about 21% each felt that quality of care would either improve or stay the same.
Some 90% of those who replied think that if they're pushed to shop more on price, it's either extremely important or very important for them to have access to complete information on the past performance of specific doctors and hospitals. Some 36% think the federal government should provide such information, while 26% think that doctors and hospitals themselves should provide it.
Here are the complete results:
From what you know of defined-contribution health plans, do you:
Option
Total
%
Favor them
229
38.29 %
Oppose them
309
51.67 %
Have no opinion
60
10.03 %
Do you think that with such a plan you would be more likely to buy generic rather than higher-priced brand-name drugs?
Option
Total
%
Yes
339
56.59 %
No
214
35.73 %
Don't know
46
7.68 %
Would you be more likely to shop for the lowest-priced physician?
Option
Total
%
Yes
94
15.72 %
No
459
76.76 %
Don't know
45
7.53 %
Would you be more likely to shop for the lowest-priced hospital?
Option
Total
%
Yes
103
17.28 %
No
435
72.99 %
Don't know
58
9.73 %
If you wouldn't be more likely to shop for the lowest-price drug, doctor, or hospital, why not?
Option
Total
%
Satisfaction with my existing medical care
155
26.54 %
Worry over the trade-off between cost and quality
334
57.2%
Convenient proximity of current health-care providers
28
4.79 %
Other
19
3.25 %
I would shop for the cheapest of all three
48
8.22 %
With defined-contribution health care, how important do you think it would be to have complete information on the past performance of specific doctors and hospitals?
Option
Total
%
Extremely important
417
69.5 %
Very important
125
20.83 %
Important
43
7.17 %
Not very important
9
1.50 %
No opinion
6
1.00 %
Who should be responsible for providing this information and guaranteeing its accuracy?
Option
Total
%
Employers
72
12.06 %
The federal government
212
35.51 %
Doctors and hospitals themselves
153
25.63 %
Other
74
12.4 %
Not sure
86
14.41 %
With defined-contribution health care plans, do you think the quality of health care in the U.S. will:
Option
Total
%
Improve
130
21.74 %
Get worse
307
51.34 %
Stay the same
123
20.57 %
No opinion
38
6.35 %
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Copyright 2002 , by The McGraw-Hill Companies Inc. All rights reserved.
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