The Center for Studying Health System Change
March 2005
More Americans Willing to Limit Physician-Hospital Choice for Lower Medical Costs
By Ha T. Tu
More Americans are willing to limit their choice of physicians and hospitals to save on out-of-pocket medical costs, according to a new national study by the Center for Studying Health System Change (HSC). Between 2001 and 2003, the proportion of working-age Americans with employer coverage willing to trade broad choice of providers for lower costs increased from 55 percent to 59 percent-after the rate had been stable since 1997. While low-income consumers were most willing to give up provider choice in return for lower costs, even higher-income Americans reported a significant increase in willingness to limit choice. Compared with other adults, people with chronic conditions were only slightly less willing to limit their choice of physicians and hospitals to save on costs. Perhaps as a result of growing out-of-pocket medical expenses in recent years, the proportion of people with chronic conditions willing to trade provider choice for lower costs rose substantially from 51 percent in 2001 to 56 percent in 2003.
http://www.hschange.org/CONTENT/735/
Comment: Respondents to this survey were asked if they agreed with this statement: “I would be willing to accept a limited choice of physicians and hospitals if I could save money on my out-of-pocket costs for health care.”
It is crucial to understand that they were not asked if they agreed with this statement: “I would prefer that my insurance plan restrict my choice of physicians and hospitals.” Yet the conclusion being drawn is that employers should offer more limited-choice insurance options.
Patients do value very highly their right to choose their own health care professionals. Baring your most intimate mental and physical issues to another from whom you seek help requires profound confidence and trust in the professional relationship. And for the great many individuals with chronic disorders, long-term continuity of this relationship is essential.
So why would so many be willing to relinquish this fundamental moral and ethical relationship? Well, this survey does provide that answer. Out-of-pocket expenses have become such a great burden, significantly impairing affordable access to care, that people are willing to give up this right to choose their professionals in order to reduce the personal debt burden of health care.
People want to have their choice of health care providers, and they want health care to be affordable. Offering more restrictive plans is not the answer since such plans would diminish choice, and they would have only a very modest impact on costs.
A single payer system would accomplish both goals. Patients would have free choice of their providers. And costs would be effectively controlled by methods that actually improve allocation of our health care resources. Why do we keep turning to the private plans to ask for highly flawed fixes to our sick health care system? Establishing our own public plan would allow us to apply the right fixes. Or does blind faith in market ideology still trump morality and ethics?