Market Pressure
You know those television commercials you always
see these days about prescription drugs; often they are there
putatively to raise awareness of diseases. Many people don’t
even know they have a disease until they see these commercials.
Of course, after they tell you about this illness, they advise
you to ask your doctors about such-and-such medication.
This marketing technique has been adopted full-force
by the big pharmaceutical companies in recent years, and it
has worked. The drug industry has grown considerably and increases
in drug costs are a large part of the reason for increases
in overall healthcare costs. And part of the reason is that
drug costs are largely invisible to many consumers: the insurance
company pays for most of it except for a “co-payment”.
There's broad agreement that patient pressure for the use
of generic drugs, when medically appropriate, can curtail
costs by offsetting sophisticated marketing by pharmaceutical
firms. Such patient pressure is generated by potential impact
on the family pocketbook. HSAs were introduced partly to create
that pressure. If people shop for health care just like they
shop for televisions or vacations, maybe the industry will
become more efficient.
Critics claim that government policy encourages people to
be less careful consumers when it comes to health
care, and that if the government changed its policy, the number
of people without coverage would shrink and the quality would
increase. That is debatable, of course, but it is the type
of thinking behind many of the libertarian think tank policies.
Market pressure. The market economy and the
"ownership economy". These buzzwords are relevant
to the ideas behind HSAs. Article about
the possible effect of HSAs on use of hospital emergency departments.
Conservative pundit George
Will wrote in May 2007: "Liberalism's goal of achieving
greater equality of condition leads to a larger scope for
interventionist government...Hence their fear of Health Savings
Accounts" Likewise, the conservative think tank Heritage
Foundation is a an advocate of HSA, claiming in a 2006 article
that HDHP insurance purchased in accordance with HSAs have
seen decreases in premiums recently in contrast to conventional
health insurance.
In an article called "Who's
Afraid of Personal Responsibility? Health Savings Accounts
and the Future of American Health Care” Richard
Kaplan suggests HSAs could bring about a “paradigmatic
shift” in consumer attitudes about health insurance.
He assesses the probably impact of HSAs according to “five
C's”
- complexity of possible configurations
- confusion over self-administration
- choice of alternative arrangements
- control
- cost of health care.
