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Consider A Doctor Who’s Not A “Preferred Provider”

March 24th, 2010 by AlanDappenMD in Primary Care Wednesdays
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Many companies and consumers are turning to higher-deductible health care plans (HDHPs) in order to keep their insurance policies more affordable. The rational basis of these plans is that since you’re using your money and you are in control, you will pay more attention to what is really being offered to you as well as to the cost relative to value. You will be more likely to challenge your doctor to provide the rationale for an expensive test or drug, and to encourage your doctor to innovate to provide lower-cost alternatives.

A trap of these new health plans, as currently structured, is that you’re herded into in-network ‘preferred providers.’  The rationale of the insurance company is that they can control doctors’ prices, thus brokering a better rate for you. They also want to use your loyalty to the network to control physicians’ practices. “Preferred,” in reality, does not refer to quality; rather it just means the doctor has signed an agreement with the insurance company, binding them to the insurance company rules, which favor the insurance company, not the patient.
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Do People Really Want More Control Of Their Healthcare Costs?

December 14th, 2009 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
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Over at The Corner, Ramesh Ponnuru theorizes that people want more control over how they spend their health care dollars:

[Ezra] Klein’s argument is that if employees understood that the employer’s alleged share of their health-care costs are really part of their wages — and if they saw it on their paychecks — they would be more supportive of cost control. I agree with that. But I assume he means (based on his examples in this op-ed) that they would be more supportive of cost controls imposed by HMOs or Congress. I think they would be more inclined to favor turning over control of health insurance from their employers to themselves, and making the cost-quality trade-offs for themselves with their own money. Under the status quo, those trade-offs are made by other people and the fact that it’s the employees’ money is obscured.

It sounds nice in theory.  But in practice it seems to be exactly wrong.

Here’s why. Read more »

*This blog post was originally published at See First Blog*