Consumer and Provider Costs

[anonymous]

Consumer and Provider Costs

Saneeka Hunter
MHA/516
March 26, 2018

Thom Sloan


Consumer and Provider Costs
With health insurance increasing in deductibles to be consumer-based and trying to encourage consumers to make better choices when it comes to their health may put a damper on people when it comes to purchasing health insurance. This can be a positive or negative effect because people want health insurance, but they do not want to pay a lot for health care coverage. With changes to federal or state health care policies, this may work for some people because they may want and need to change their lifestyles to improve their health and it could have a negative impact on health insurance companies because of the rising costs of deductibles.

Positive and Negative Effects on the Impact of Federal Health Care Policies on Consumer Cost

Because there are people who have a high-income and low-income everyone will not have to pay the same rate when it comes to healthcare insurance. The spending patterns will be different, people with low incomes may not have to pay a high-deductible and people with a high-income may be the ones who will have to pay the higher-deductible. This could also make it hard for people with low-incomes because when prices increase by regulation, they have an adverse effect on low-income households, meaning that the poorest people will have to pay the most for healthcare insurance (Chambers & Collins, 2016). With the Affordable Care Act (ACA) greater financial stability for individual market insurers should be good news for consumers; meaning that it would lower rate increases and growing competition benefits in 2018, only if it were not for federal policy uncertainty (Aron-Dine, 2017). If people who have low-incomes are getting higher pay from their employer than they would be able to afford health insurance because of the expectation for economy-wide trend growth in medical costs (Aron-Dine, 2017). This would be something that will be good for people who work hard for a living and cannot afford to get health insurance for themselves and family because of how high costs are getting. Aiming to get people who live healthier lifestyles is a good thing but raising the costs of health care coverage can put a strain on people who live healthy lifestyles, but do not make enough money to afford health care coverage.

Conclusion

The fact that federal policies can help encourage people to want to live a healthier lifestyle so that they will not have to pay high-deductibles for health care insurance is a good thing, but we cannot forget about the people who probably already live these healthy lifestyles and still cannot afford to see a physician on the regular if they wanted to. Being a consumer, we want healthcare services, but we also want to be able to afford healthcare insurance, with federal policies this can put people in a position to not have health insurance because of the costs, so the insurance company still loses out because they are charging too much.



References

Aron-Dine, A. (2017, September). Health Care: Issues Impacting Cost and Coverage. Center on Budget and Policy Priorities, (),. Retrieved from https://www.cbpp.org/health/health-care-issues-impacting-cost-and-coverage

Chambers, D., & Collins, C. A. (2016, February). Share Tweet Print How Do Federal Regulations Affect Consumer Prices? An Analysis of the Regressive Effects of Regulation. Mercatus Center, (),. Retrieved from https://www.mercatus.org/publicatio...prices-analysis-regressive-effects-regulation

Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012, April). Impact of Federal and State Legal Trends on Health Care Services. US National Library of Medicine National Institutes of Health, 37(4), 218-220, 224-226. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3351856/

 

[K Turner]

Consumer and Provider Costs​

Health insurance plans have created a system of high-deductible insurance policies and narrow networks due to federal policies and service requirements, adding to the out-of-pocket costs incurred by consumers. This system seems to cater to younger, more sophisticated generations who, if held more accountable from a financial standpoint, will do more to live healthier lifestyles, thereby adapting and benefitting from being low-cost users (Waters, Chang, Cecil, Kasteridis, & Mirvis, 2011). Consequently this system leaves older consumers with little choice but to choose plans that offer more incentives but also less care, higher mortality rates, and more overall expenses. The goal of this article is to explore both the positive and negative effects of federal and state health care policies on consumer costs.

Positive Effects​

Over time, high-deductible insurance policies have affected consumers’ decisions to obtain unnecessary health care services, ranging from ambulance transport and emergency room services to scheduled visits with primary care physicians (Scheffler & Felton, 2006). More responsible decisions are being made by consumers regarding the diet, exercise, and recreational habits for their families and themselves as a means of sustaining their health. Additionally, many explore alternative, home-based remedies that are just as effective as traditional medicine and sometimes use health care providers as a last resort. Time and money are saved by consumers who would otherwise incur hundreds of dollars in expenses just to be diagnosed with a common cold, strained muscle, or other ailment that could have been treated with over-the-counter medicines and rest (Waters et al., 2011).

Negative Effects​

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The problems with high-deductible insurance policies and narrow networks begin when saving money supersedes the need to obtain medical care (Brown, 2017). Over time, this type of poor judgement can become habitual if previous instances seemed to have “worked” based on the outcomes of those chosen remedies. Consumers may not realize that the self-care measures used are simply band-aids that provide temporary solutions, which eventually lead to more serious and life-threatening diagnoses that require more expensive treatments. In more severe instances, health might only be maintained through comfort measures because of the amount of time passed and damage done to the body. Expenses continue to accumulate during this time as well.

Conclusion​

Validations and concerns will always surround federal and state policies as well as the adequacy of protections in place for consumers regarding the costs involved with health insurance. The system of high-deductible insurance policies and narrow networks continue to affect health care decisions from an economic standpoint, and its goal of pushing consumers to make more responsible decisions regarding treatment options and lifestyle choices is working for some, but hurting others in the process. Even with the positive outcomes presented, an assumed risk lies in making self-care decisions because consumers are not professionals; their methods of treatment are not guaranteed and could result in further health complications.

References​

Brown, E. C. F. (2017). Consumer Financial Protection in Health Care. Washington University Law Review, 95(1), 127–201

Scheffler, R. M., & Felton, M. C. (2006). Consumer-Driven Health Plans: New Developments and the Long Road Ahead. Business Economics, 41(3), 44. https://doi.org/10.2145/20060305

Waters, T. M., Chang, C. F., Cecil, W. T., Kasteridis, P., & Mirvis, D. (2011). Impact of high-deductible health plans on health care utilization and costs. Health Services Research, 46(1 Pt 1), 155–172. https://doi.org/10.1111/j.1475-6773.2010.01191.x