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WISCONSIN LEGISLATIVE UPDATES
Home > Links > Wisconsin Legislative Updates
November 07, 2007
Consumer control is the best course. By Rep. Leah Vukmir
A quiet revolution is transforming the health care industry and challenging the status-quo. Employers, fed up with the current system, are moving towards consumer-driven health care (CDHC). They are empowering their employees to manage more of their health care dollars and decisions. Assembly Republicans are leading the way by promoting CDHC reforms that put individuals – not government – in charge of their health care.
Unleashing an army of consumers with information and tools with which to make personal decisions about health care is the only way to lower health care costs, expand access, and protect the high quality health care we have come to expect in Wisconsin.
Decades of government regulation and top-down reforms – such as managed-care that sought to control costs by limiting patient and physician choices – have failed. Employers are pressuring insurers to control costs. Insurers are working to leverage lower prices from providers. Providers are consolidating to form larger groups to resist those pressures. As a result, the system has become inefficient, expensive, and less responsive.
While individual health care providers may be responsive to a patient’s needs, the system they work in is not. Consumers are insulated from plan options, cost and financial incentives for proper utilization. Having a third-party pay nearly 85 cents out of every health care dollar has placed the consumer outside of the system and provides little inducement for individuals to consider costs. This lack of consumer pressure has allowed the health care industry to be immune from basic market forces. Government mandates and regulations have worked to limit choices and stifle market reforms, not only for insurers but also providers.
Putting consumers in charge of their own health care is a significant paradigm shift. Consumerism forces providers to compete. Competition improves quality, lowers costs and drives innovation. Consumers evaluate cost, quality and value in every segment of our economy – except health care – because the consumer has never been in charge.
A well-designed CDHC plan protects the individual from large out-of-pocket costs while providing them with incentives to find savings. Most plans provide essential preventative care and wellness incentives so individuals can directly benefit from making reasoned choices. Offering Health Savings Accounts (HSAs) allows consumers direct control over a larger portion of their health care dollars and empowers them to make choices about providers and care. Employers offering HSAs realize significant savings in premium costs which allows them to offer insurance to more workers.
Consumers must also have access to relevant and objective cost and quality information about hospitals and doctors.
Opponents falsely claim that CDHC is only for the healthy, yet significant innovations are occurring in chronic disease management that are improving outcomes while lowering costs. At Marshfield Clinic and other places, focused, integrated health care teams are changing their approach to comprehensive care for illnesses such as diabetes and heart disease – significant cost drivers.
Our agenda also calls for reforming BadgerCare to empower low-income individuals to obtain their own coverage rather than suffer through the current managed-care maze. Innovative, low-cost private insurance plans that transform recipients into consumers will expand access and improve care.
Finding solutions to our health care problems requires less government – not another centralized authority that collects our money and allocates it on our behalf. Big government plans may temporarily address the issue of access but do nothing to control costs. The result would be the loss of quality and personal freedom. That is a price none of us should be willing to pay.
