Employers like expense-shaving consumer-driven health plans, according to a survey by the Employee Benefit Research Institute Research and the Commonwealth Fund. But consumers? Not so much. The survey reached 3,158 privately insured adults aged 21 to 64, and used that data to project U.S. trends. The two groups found that only 1 percent of privately-insured Americans--about 1.3 million individuals--are enrolled in CDHPs, which often have a $1,000 initial deductible for individuals and a $2,000 deductible for families. Meanwhile, 7 percent of those surveyed, or 8.5 million consumers, were enrolled in CDHPs but don't have a health savings account, leaving them vulnerable to small emergencies and unlikely to seek preventive care. (EBRI noted that these folks simply can't afford to contribute to HSAs, and that their employers don't kick anything in either.) What's worse, they're likely to cut back on doctor visits and prescription use, EBRI found.
Nonetheless, employers continue to pile on, attracted by low premium costs, according to research by Mercer Health & Benefits. To my mind, that's penny-wise, pound-foolish behavior which will backfire spectacularly when employees end up in the hospital with costly conditions after neglecting minor issues and preventive care. Yes, I know that some CDHPs are being designed to include free preventative care and such, but generally speaking, this model works against good care management. On the whole, CDHPs are counterproductive, built on more or less untenable (and even, I'd suggest, ethically suspect) principles. But hey, Karen Ignani, if you want to debate me on the CDHP issue, please feel free to drop me a line. Bring it on!