Americans May Accept Some Managed Care
The results may reflect what insurers already know about U.S. consumers: Some are willing to accept restrictive plans in exchange for lower costs, while others want more freedom even if it means higher prices.
Those preferences gave rise to increasingly popular preferred provider organizations (PPOs), where patients face fewer restrictions and have more choices of doctors. They've also led to a market where employees have a much wider choice of differently priced plans than they did 10 years ago, Schur says.
Insurance costs continue to rise despite the changes, helping to grow interest in health savings accounts. The plans allow workers to save money for health care in tax-free accounts but also give consumers more responsibility and more financial risk for their own health decisions.
The plans enjoyed the strong support of President George Bush in the election campaign and have seen a small but growing number of employers offering them, says Jon Gabel, vice president of health systems studies at the Health Research and Educational Trust.
Between 1.5 and 2 million Americans now use the health savings accounts, which were passed by Congress last year.
John Bertko, the chief actuary at the Humana insurance company, says the plans may have cut costs by as much as 5% among 100,000 customers who've used them this year. Bertko calls the figure "speculative," noting that it is too early to tell if the accounts can save money while maintaining quality or if consumers will even use them.
Others agree. "We should probably wait a little while before we decide if they're working or not," says Gary Claxton, vice president of the Kaiser Family Foundation.