Comments

Health Affairs encourages readers to engage in discussion via comments on our Web site.

• To RESPOND to a particular article: Click on the link "Submit a response to this article" in the box at the top right-hand corner of the article.
• To READ responses to a particular article: Click on the link "View responses" in the box at the top right-hand corner of the article.

Comments to:

James C. Robinson and Paul B. Ginsburg Consumer-Driven Health Care: Promise And Performance Health Affairs, March/April 2009; 28(2): w272-w281. [Abstract] [Full Text] [PDF] [Reprints & Permissions]

Comments:Submit a response to this article

Comments published:

Consumer-Directed Plan Sales: Nothin' Anemic About It

Greg Scandlen   ( 30 January 2009 )

Consumer-Directed Plan Sales: Nothin' Anemic About It 30 January 2009
Greg Scandlen, Director CHCC at the Heartland Institute Send comment to journal: Re: Consumer-Directed Plan Sales: Nothin' Anemic About It greg{at}chcchoices.org Greg Scandlen	I’m glad the authors agree with us that "when in possession of adequate information and faced with appropriate incentives, consumers make better choices for their own health than does any third party." My objection is the way the authors cherry-pick the evidence on actual experience. They acknowledge that "the HDHP represents the most important product innovation in health insurance since the point-of-service product," but they say HDHP sales have been "anemic." For support they cite AHIP’s census of HSA-qualified health plans. But AHIP counts only plans that are HSA-qualified. It does not count HRA plans or stand-alone HDHPs. The authors ignore the CDC’s annual National Health Interview Survey that found that over 20% of the under-65 population is now enrolled in HDHPs. Ain’t nothin’ anemic about that. This finding was confirmed by the KFF/HRET annual survey that found 18% of workers are in HDHPs. The authors cited the KFF/HRET survey in arguing that only 8% of workers are in "HDHPs with a savings option" but missed that 18% are in "the most important product innovation"? The behavioral impact of the HDHP applies with or without the savings option. More astonishing is the authors’ disregard of those behavioral changes. In the past few months reports have been released by Mercer, WellPoint, CIGNA, BCBSA, UnitedHealthcare, Aon Consulting, and even the chronically skeptical EBRI, all showing that CDHP enrollees pay more attention, seek information, participate in wellness and prevention programs, choose lower-cost treatments, and save substantial amounts of money for themselves and their employers.