{"id":2152,"date":"2014-06-16T15:40:39","date_gmt":"2014-06-16T05:40:39","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=2152"},"modified":"2014-06-16T15:41:05","modified_gmt":"2014-06-16T05:41:05","slug":"selecting-health-insurance-based-on-value-of-care-covered","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=2152","title":{"rendered":"Selecting health insurance based on value of care covered…"},"content":{"rendered":"

A solid idea.<\/p>\n

Allowing consumers to pick how “fruity” they want their cover to be. This takes self-serving autonomy\u00a0from the clinicians and places it back with the patients, who no longer have to cross-subsidise silly, exorbitant care.<\/p>\n

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http:\/\/www.nytimes.com\/2014\/06\/10\/upshot\/how-to-pay-for-only-the-health-care-you-want.html<\/p>\n

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How to Pay for Only the Health Care You Want<\/h1>\n
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Credit<\/span>Magoz<\/span><\/figcaption><\/figure>\n
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By\u00a0Austin Frakt andAmitabh Chandra<\/p>\n<\/div>\n

One reason health insurance is expensive is that most plans cover just about every medical technology \u2014 not just the ones that work, or the ones that are worth the price. This not only drives up costs, but also forces many Americans into purchasing coverage for therapies they may not value. But there\u2019s no reason things couldn\u2019t be different, and better for consumers.<\/div>\n

Consider the latest technology for treating prostate cancer: the proton beam. It\u2019s delivered with a football field-size machine costing well over $100 million. Per treatment, this therapy costs at least twice as much as alternative approaches, but is no more effective. Many health plans cover it and other therapies of low or uncertain value because they pay for anything that physicians deem medically necessary even when evidence suggests otherwise. And, without even knowing it, Americans pay for it in higher premiums.<\/p>\n

It doesn\u2019t have to be this way. If plans could compete on the basis of the therapies they cover, consumers could decide what they wish to pay for. This sounds complicated, but it need not be.<\/p>\n

Health plans could define themselves at least in part by the value of technologies they cover,\u00a0an idea proposed<\/a>\u00a0by Professor Russell Korobkin of the U.C.L.A. School of Law. For example, a bronze plan could cover hospitalizations and visits to doctors for emergencies and accidents; genetic diseases; and prescription drugs that keep people out of hospitals. A silver plan could cover what bronze plans do but also include treatments a large majority of physicians find useful. A gold plan could be more inclusive still, adding coverage, for instance, for every cancer therapy shown to improve patient outcomes (no matter the cost) as long as it was delivered at a leading cancer center. Finally, a platinum plan could cover experimental and unproven cancer therapies, including, for example, that proton beam.<\/p>\n

This way, nothing would be concealed or withheld from consumers. Someone who wanted proton-beam cancer treatment coverage could have it by selecting a platinum policy and paying its higher premiums. Someone who did not want to pay higher premiums for lower-value care, in turn, could choose a bronze or silver plan. This gives a different, but more useful, meaning to the terms \u201cgold,\u201d \u201csilver\u201d and \u201cbronze\u201d than they have in the new insurance exchanges today.<\/p>\n