A new nationwide survey by the Texas Medical Center Health Policy Institute in Houston found that consumers and physicians blame health insurers, drug companies and medical device manufactures for rising healthcare costs.
Survey respondents said two ways to cut healthcare spending are to increase costs on those “with poor health habits” and to allow payers to offer catastrophic health insurance plans with limited benefits.
"The Nation's Pulse: The Texas Medical Center's Consumer & Physician Survey" involved more than 9,000 consumers across 15 states and 450 physicians across the country.
Nearly half of physicians and slightly more than one-quarter of consumers surveyed blamed insurance companies for healthcare costs. Another 19% of physicians and 30% of consumers placed the blame on drug and device manufacturers.
An interesting tidbit — neither physicians nor consumers blamed hospitals and doctors for rising healthcare costs, even though those groups are the ones who directly bill patients. This shows that people are more apt to blame big, faceless healthcare organizations than their providers or local hospitals.
Both physicians and consumers largely agree that increasing health insurance costs on smokers and obese Americans and taxes on unhealthy food are ways to decrease healthcare costs. However, the two groups also said insurance benefit design can play a role in bringing down healthcare costs. The same percentage of physicians and consumers (23%) said affordable catastrophic health plans would be the best way to cut healthcare costs.
Despite their popularity, these policies don't represent evidence-based best practices, and don't fit in well with current law. Taxes on unhealthy foods haven't been shown to reduce obesity or heart disease. Also, catastrophic coverage can lead to overwhelming out-of-pocket costs for consumers.
A form of catastrophic plan, high-deductible health plans (HDHPs), already make up about one-third of employer-based health plans. Employers have increasingly viewed HDHPs as a way to contain premium increases, and that strategy is working as employer-based plans have seen only modest premium increases over the past five years. The downside is that those plans have also meant more out-of-pocket costs for individuals and families.
Survey respondents said affordable catastrophic plans that only cover “critical situations,” such as accidents, pregnancies and major illness, would help cut costs. The Affordable Care Act (ACA) requires insurers provide essential health benefits like wellness visits, emergency care, hospitalization, outpatient care, pregnancy and newborn care, prescription drugs and mental health and substance abuse services. That means the catastrophic plans described in the survey can’t happen unless Congress makes changes to the ACA law or repeals it and replaces it without something else, which Republicans have been working on this year.
The downside to limited catastrophic plans is that one never knows what health issues may result in the coming year. So, yes, the described catastrophic plans would provide more affordable options for Americans, but would also have limited coverage with no safety net. These plans would result in people paying more out-of-pocket when they need healthcare services.
However, for people surveyed, those plans are seen positively because healthcare has grown unaffordable. The survey found that 49% of consumers said they have cut spending elsewhere to pay for healthcare.
But what’s considered affordable healthcare? Most uninsured respondents said only 2% of their income on healthcare is affordable. That’s much lower than what the ACA believes. In the ACA, health insurance is considered affordable as long as it doesn'do foot cost more than 8.2% of income. This means there is even a disconnect between what Americans think is affordable and what is law.