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In response: Choice, access: private alternatives can lower health care costs

Opinion by Stephen Akerman

I am always struck at how people use the good health impacts of medicine to justify forcing individuals to accept a government mandate. Ms. Margaret Henbest, and other supporters of Your Health Idaho, are doing just that (“Essential Benefits will help state residents stay healthy, control costs,” Feb. 5, Idaho County Free Press).

Under the guise of assertions that access to things like preventive care for chronic diseases, mental health treatment or prescription drugs, they justify telling what kind of insurance you must have. It assumes you and your families lack common sense. If you do not agree with their approach, they cancel your insurance policy because it didn’t meet the standard they set for you. Want to know why you lost your insurance? It didn’t meet the 10 Essential Health Benefits rule (in Section 1301 and 1302) of the Affordable Care Act. Wonder why the average deductible increased by 100 percent and why deductibles on Idaho’s health exchange have a high-end cost of $10,000? They are the result of mandating benefits upon people, instead of letting them choose what they need for themselves and their families.

They believe the only way to cut health care costs, which have been rising, is to impose a single set of benefits on every individual. This forces people to pay for things they don’t need, wasting their limited dollars. However, research shows savings can be found through private alternatives for patients that focus on incentives and rewards. I have seen it in my work as a competitive intelligence analyst for disease management companies, insurance companies, pharmacy benefit management firms, medical messaging and other technology providers and hospital billing companies.

Further, through decentralizing and opening up the insurance and provider markets to competition, we can cut the administrative and other costs that come with a few companies controlling so much of health care access and delivery.

Supporters of Your Health Idaho have already shown the bankruptcy of their approach and the current system. The health exchange was estimated to cost $20 million; it is now costing $70 million. And, not one dime goes to medical care. The U.S. Preventive Task Force recommended women wait until age 50 before getting a mammogram. Medicaid has gone from 6.5 percent of Idaho’s budget in the early 1990s to 17 percent today and yet, the same chronic issues persist. If we stay on this path, people will suffer.

We need to open up this system, focusing on choice, access, incentives and rewards, and technology. There are proven savings strategies for those chronic diseases that require more intensive care, along with prevention strategies and routine care. But, it starts with people being in charge.

Stephen M. Ackerman teaches economics and political science at the College of Idaho and on-line. He is the former president of the Meridian-based Competitive Intelligence firm, Provizio, which focused on the health care industry. He is a former analyst on the President’s Base Closure Commission.


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