Thoughts on high-deductible health plans

Okay, don't want to go into this in too much detail, but the Wall Street Journal today published a piece about how high-deductible health plans (HDHPs) with health savings accounts aren't gaining traction with workers. To me, this seems kind of self-explanatory. I mean, when given a choice between a plan that will pay for a lot of things for me, and a plan in which I have to save my own money and make a lot more choices, I'm going to choose the easy, cheap one. Of course, if you are telling me I have a choice between no health care and a HDHP with an HSA, I'm choosing the HDHP/HSA. Something is better than nothing.

One huge problem is, and the Journal notes this, that there simply isn't enough information out there for consumers to make educated choices about price versus quality in choosing doctors. If I was looking for a doctor to perform a heart bypass, would I really want the cheapest? But if I have this plan, that's what I'm constantly going back to. Not to mention, plenty of sites looking to compile data on costs have found that hospitals don't just toss out a price for any given procedure. Hospitals have one price for one insurance company, one price for another, one price for Medicaid and Medicare, and one price for the uninsured. Trying to get a straight answer about final cost is not easy.

On top of costs, where would I find information about quality of care? There isn't easily comparable data out there. I read some recent coverage (I forget where) about different companies trying to set up quality data about hospitals and even states, like New Jersey for heart surgery, that rate doctors and hospitals about very specific procedures. But really, the U.S. health care system just isn't there yet. It's not comparable data ... some sites measure quality in different ways, making a hospital good on one site and bad on another.

So really, it's no surprise that HDHPs/HSAs haven't caught on yet. They are just TOO much work. Health care is important, but I just want it, I don't want to have to research it. I have other things to do. Maybe Bush is right when he says we need a culture shift toward people acting more like consumers about their health care. But right now, it's just not easy enough to make it worthwhile.