The Republican’s approach to health care reform is summarized in The Patients’ Choice Act outline.
This is a fascinating proposal on a number of levels. First there are a number of reasonable ideas, some even surprising coming from the right. For example, the push for universal access to affordable health care conflicts with the right’s argument that this would result in “rationing.”
A closer examination reveals that the document has adopted the rhetorical tactics outlined in Luntz’s 10 pointers in “The Language of Healthcare 2009.”
Even the name “The Patients’ Choice Act ” is rhetorically carefully chosen, the implication being that other approaches deny patients’ choices.
The main approach to the proposal is a few tweaks to private health care insurance regulations will allow every citizen to choose the type of health insurance coverage that’s right for them. One thing that’s glaringly misleading is the notion that consumers would have a meaningful choice. How can this be?
Let’s look at the top 10 benefits typical of any plan: premiums, plan type, office visit copay for primary doctor, office visit copay for a specialist, coinsurance, annual deductible, annual out-of-pocket limit, lifetime maximum, HSA eligibility and out-of-network coverage. Each of these benefits has a number of different options. It is easy to see that then number of combinations of these benefit options result in an a enormous number of plans available.
While this may seem advantageous to the consumer, it turns out it’s not. Barry Schwartz, PhD, a Swarthmore College psychologist and author of “The Paradox of Choice: Why More is Less” makes the argument that when faced with an overwhelming number of choices, we often make a bad choice. The goal in choosing a health care plan is to maximize the coverage you need for the least cost. But few, if any, can predict the coverage they may need. Because of the large number of plans, finding comparable plans is difficult. In addition each insurer negotiates different prices for different services from providers, making it virtually impossible for the consumer to determine their ultimate costs when choosing between equivalent plans from different insurers.
The Patients’ Choice Act is interesting, but fails to address the most important reform when it comes to “choice” in determining a health care plan.