Patient Needs Larger Role in Health Care

The arguments made here and those made by Smith may have many loose ends. However, we both are getting at one of the most important aspects of reforming the health care system which isn't receiving enough attention, and that is increasing the responsibility of the patient/doctor team for determining cost/benefit relationships. We need to diminish the role of profit motivation in health care and increase the discipline of consumer selection. The government can establish programs, like the one suggested as an item for discussion, to support the development of this consumer centered health care system.

We can't get effective control of health care costs until the patient/consumer has a central role.

Meanwhile, the business plan of some insurance companies would necessarily change if a proposal like this was to be implemented. Companies like Cigna(CI), UnitedHealth(UNH), and Aetna(AET) have a business model based on the prepaid health care process.

With the proposed high deductible catastrophic care coverage process, the business model is more like property and casualty, life and long-term disability insurance, such as Aflac (AFL ), Travelers(TRV) and Hartford(HIG) offer today. Employment would decline in the areas of claims processing, although the number of insureds would increase. The gross premiums received would be significantly reduced, as would claims paid.

Revenue and earnings of health care insurance companies would probably be reduced, although margins might improve.

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