Does the New Health Care Shape Up?


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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