If your employer got to choose where you lived — whether in a house or apartment — and what you drove — whether a car or an S.U.V. — would you mind?
Of course. These are personal choices. Unfortunately, though, Americans have surrendered a big personal decision to their employers: Health insurance.
Employers mostly buy health insurance as lump, group coverage with no consideration for the individual employee. America seeks to embrace its diversity, but falls short when it comes to medicine.
Ironically, medical professionals are developing the capacity to provide personalized care based upon genetic and personal characteristics, but while science and medicine are forging ahead, the health insurance market is lagging.
Under most health care plans a third party determines benefits. Negotiations are done between insurance companies and employers or government bodies to set coverage and mandates. This system denies input from the individual. Under these arrangements, personalized health care doesn’t exist.
To the patient’s detriment, this third-party system has led to a breakdown in the doctor-patient relationship. Since doctors and patients must both turn to a third party provider to determine what will be paid for, neither is fully involved in determining what is medically appropriate.
Americans have different medical needs, and those needs change over time. Individuals require different treatments and medical procedures, and hold different beliefs about what is right and wrong in the provision of health care services.
Sadly, our current health care system is unlikely to ever reflect those differences in needs and beliefs. That’s why it’s time to provide a broad choice of health plans — to meet individual needs and to ensure that individual ethical and moral beliefs about the provision of care and medical treatments are not violated.
Personal choice helps remove medical decisions from impersonal employers and governments. It empowers the individual to choose plans that are appropriate and avoid cultural or ethical conflict.
Effective health care reform should also enable individuals and families to have personal ownership of their plans.
Ownership allows greater personal control of how money is spent, which is far better than the current system where employers and governments make those decisions. This choice and ownership would also allow plans to become portable from job to job and through career transitions.
One way to accomplish this is to move from employers providing set benefits to employees towards employers providing a defined dollar contribution towards the health plan of their choice.
This kind of consumer-driven approach is similar to the Federal Employees Health Benefits Program (FEHBP). Millions of federal workers, armed with complete guides and online tools, chose from more than 240 competing health plans nationwide. In any given area of the country federal workers can choose from up to two dozen plans.
Although not as broad, some private sector firms allow plan choices too. Vivius, a consumer-choice health care company based in Minneapolis, has developed a “build-your-own health plan” Web application. Through this program employers can offer extensive provider choices, thus encouraging employee involvement in choosing their level of coverage, their providers and their premiums and co-payment amounts. Likewise Hewitt Associates, a major consulting firm, has a “Build Your Own” health plan that gives enrolled employees many options.
With advances in medical science and treatment options, the demand for personal choice will only grow. In response, lawmakers should adjust the federal and state policies that govern the health care system to encourage personal choice and competition. That includes individual health care tax credits and changes in the rules governing health insurance, including the right to buy better plans in different states.
Individual health care tax credits would enable individuals to purchase the health plans of their choice. It’s time to give Americans the same freedom of choice in health care they enjoy in every other sector of the economy.
Christina Sochacki is health policy fellow in the Center for Health Policy Studies at The Heritage Foundation.