Is the Cost of Healthcare Insurance a Throttle or an Accelerator?

By Stewart Gandolf
Chief Executive Officer

Healthcare Cost Coin Toss

Healthcare Cost Coin Toss

There’s no doubt that Americans are going to the doctor less frequently than they did a few years ago. The downtrend in patient visits is well documented…there’s plenty of empirical as well as anecdotal evidence.

We hear about it routinely from our clients in primary care practices, which is not surprising. But it’s a bit of a shocker when pediatrician offices tell us that they are tracking fewer patient visits.

The primary reason cited is not the high number of uninsured Americans, although that’s certainly a factor. It is, by many sources, the increase in high deductible health plans offered by more employers combined with higher copays on these and other health plans.

In other words, healthcare costs are increasingly shifting away from the employer to the insured employee.

When Blue Shield of California cancelled (yet another) planned rate increase, the Los Angeles Times reported on this trend citing the cost savings to consumers, but with a benefit to Blue Shield as well. “The healthcare premium increase, averaging 6.5% and going as high as 18%, would have been the third in recent months by the insurer, which had faced pressure from state officials and consumers,” according to the Times.

But, they continue, “Blue Shield of California’s decision to cancel a big rate hike for nearly 200,000 people followed mounting pressure from the public and political leaders. But an unforeseen factor may have made the retreat easier for the company to accept: It’s paying out less for medical claims than it had anticipated. And it’s not just Blue Shield. Major insurers including WellPoint Inc. and Aetna Inc. also say that medical spending has been lower than projected recently, saving the companies millions of dollars in payouts.”

There are two sides to this coin. From the perspective of insurance companies and other advocates of reducing healthcare costs, Americans overuse medical services because they usually don’t have to pay much out-of-pocket (if anything) for many healthcare services. This side of the argument says that the only way to bring healthcare costs under control is to shift more expense to patients. Medical costs to the insured are “too-cheap,” so raise the gate, and throttle-back care and overall costs.

Then there’s the other side of this coin. The counterargument is that the cost pressure that keeps patients away from the doctor is going to actually increase healthcare costs in the long term. Preventative and early, proactive care for a medical issue will fester into more serious—and expensive—healthcare problems and remedies as untreated problems and conditions get worse.

What’s your take on this discussion? Take a look at the Los Angeles Times article as background, and let us know what you think. Or connect with us here, and share your thoughts about a marketing response to fewer patient visits in your practice or healthcare organization.

Stewart Gandolf
Chief Executive Officer at Healthcare Success
Stewart Gandolf, MBA, is Chief Executive Officer of Healthcare Success, one of the nation's leading healthcare and digital marketing agencies. Over the past 20 years, Stewart has marketed and consulted for over 1,000 healthcare clients, ranging from practices and hospitals to multi-billion dollar corporations. A frequent speaker, Stewart has shared his expertise at over 200 venues nationwide. As an author and expert resource, Stewart has also written for many leading industry publications, including the 21,000 subscriber Healthcare Success Insight blog. Stewart also co-authored, "Cash-Pay Healthcare: Start, Grow & Perfect Your Cash-Pay Healthcare Business." Stewart began his career with leading advertising agencies, including J. Walter Thompson, where he marketed Fortune 500 clients such as Wells Fargo and Bally's Total Fitness.



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