Consumer Costs

[jramos716]

Policies and regulations can prove costly to producers and consumers in every industry, including health care. Regulations often increase the cost of doing business, and to offset these costs, companies raise prices for consumers. In health care, policies and regulations are impacting consumer costs in both negative and positive ways.

At the federal level, the individual mandate is a perfect example of how federal regulations have had a negative impact and increased consumer costs. Under the Patient Protection and Affordable Care Act this mandate increased the number of Americans with health care coverage. But as a direct result of more insured people and increased utilization of health benefits, there was an increase in deductible and premiums. Bronze and silver plans within these new insurance marketplaces have average deductibles of $5,181 and $2,927. High-deductible plans encourage consumers to seek high value care and shop around for better prices (Grande, 2016). Most Americans choose plans with higher deductibles because these plans have more affordable premiums.

Consumer-directed health care has shown to increase deductibles and premiums. However, one positive impact is the increase in price transparency. To encourage lower prices for health care services, some states have mandated that claims data from all payers be made public, while others strongly encourage it. An all payer claims database is an effective way that states are hoping to increase consumer transparency in relation to health care quality, safety, and most importantly costs. These state sites list cost information for medical procedures in hopes to influence consumer choices and help achieve lower healthcare costs. Now that consumers have access to compare prices on these public websites, health care providers are more conscious to offer competitive pricing (Castellucci, 2017).

Another result of rising consumer costs is a growing direct-to-consumer (DTC) medical marketplace. This market allows companies to perform tests without a physician being involved. The DTC market now offers genetic, blood, imaging, urine and saliva testing to screen for cancer and other diseases at a low cost to the patient (Rockwell, 2017). Health care consumers may take advantage of these services to avoid unnecessary physician visits and out of pocket costs.

Making better heath care choices seems to be the trend and future of our health care delivery system. Federal and state policies are impacting health insurance plans which can result in higher out of pocket costs for consumers. However, there are some policies which are requiring or encouraging price and quality transparency to make patients better consumers. In addition, consumers can order tests from DTC companies without the order or prescription of a physician.

 

[william the wie]

Good thread idea and great data but some of the sources you have used are addicted to jargon. Break the OP into multiple threads and see if that works better.

 

[GHook93]

Policies and regulations can prove costly to producers and consumers in every industry, including health care. Regulations often increase the cost of doing business, and to offset these costs, companies raise prices for consumers. In health care, policies and regulations are impacting consumer costs in both negative and positive ways.

At the federal level, the individual mandate is a perfect example of how federal regulations have had a negative impact and increased consumer costs. Under the Patient Protection and Affordable Care Act this mandate increased the number of Americans with health care coverage. But as a direct result of more insured people and increased utilization of health benefits, there was an increase in deductible and premiums. Bronze and silver plans within these new insurance marketplaces have average deductibles of $5,181 and $2,927. High-deductible plans encourage consumers to seek high value care and shop around for better prices (Grande, 2016). Most Americans choose plans with higher deductibles because these plans have more affordable premiums.

Consumer-directed health care has shown to increase deductibles and premiums. However, one positive impact is the increase in price transparency. To encourage lower prices for health care services, some states have mandated that claims data from all payers be made public, while others strongly encourage it. An all payer claims database is an effective way that states are hoping to increase consumer transparency in relation to health care quality, safety, and most importantly costs. These state sites list cost information for medical procedures in hopes to influence consumer choices and help achieve lower healthcare costs. Now that consumers have access to compare prices on these public websites, health care providers are more conscious to offer competitive pricing (Castellucci, 2017).

Another result of rising consumer costs is a growing direct-to-consumer (DTC) medical marketplace. This market allows companies to perform tests without a physician being involved. The DTC market now offers genetic, blood, imaging, urine and saliva testing to screen for cancer and other diseases at a low cost to the patient (Rockwell, 2017). Health care consumers may take advantage of these services to avoid unnecessary physician visits and out of pocket costs.

Making better heath care choices seems to be the trend and future of our health care delivery system. Federal and state policies are impacting health insurance plans which can result in higher out of pocket costs for consumers. However, there are some policies which are requiring or encouraging price and quality transparency to make patients better consumers. In addition, consumers can order tests from DTC companies without the order or prescription of a physician.

I do Corp Compliance for a too big to fail bank. There is absolutely a correlation between regulations and cost to the business/consumer. Esp the 1000+ page monstrosity regulations that Congress has produced over the last few decades. Take the ABC regs. Most of these regs implement 1000+ page monstrosities (i.e. Reg X for RESPA, Reg B for ECOA, C for HMDA, Z for TILA, DD for TISA, etc). These regs are so massive they needed further regs to implement them. Smh

You need attorneys to read and interpret the regs, and create legal requirement (many times hiring outside counsel), you need compliance officer and attorneys to create policies, procedures and controls, you need compliance officers and attorney to do risk assessment to ensure the controls adequately address risk, you need a testing and monitoring team to test the controls and make sure the business is actually executing the controls, then you need an exam management team to address the numerous regulator exams. They audit company’s risk mitigation if said exam.

Compliance Officers and Attorneys (not to mention outside counsel), plus software system and compliance programs as a whole are not cheap. In fact they are becoming most company’s largest operation cost.

This massive operation cost prevent new company’s from entering the market and forces many small businesses to close there doors. These arbitrarily limits competition. Lack of competition only increases cost more (not to mention reduces quality and consumer service).


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[dblack]

Consumer-directed health care has shown to increase deductibles and premiums. However, one positive impact is the increase in price transparency. To encourage lower prices for health care services, some states have mandated that claims data from all payers be made public, while others strongly encourage it. An all payer claims database is an effective way that states are hoping to increase consumer transparency in relation to health care quality, safety, and most importantly costs. These state sites list cost information for medical procedures in hopes to influence consumer choices and help achieve lower healthcare costs. Now that consumers have access to compare prices on these public websites, health care providers are more conscious to offer competitive pricing (Castellucci, 2017).

The problem isn't price transparency. The lack of transparency is merely a symptom of a deeper problem: people don't care what health care costs because they aren't paying for it. In fact, once a patient has met their deductible, there's a strong incentive to choose the most expensive options at every turn. It's reasonable to assume that the more expensive service is better. If you're not paying for it, or paying a very small percentage of the cost, why not opt for the 'Cadillac'?

The problem with health care is health insurance. And the problem with health insurance is that health insurance consumers have delusional expectations. We've come to think of health insurance as a club you join to get free health care. And now we're convinced that if we can get everyone to join, everyone can get free health care. But, in the end, reality doesn't work that way - so we turn to government.