Health Plans: Removing Costs Can Spark Prevention

Healthcare experts say insurers and employers can implement changes to help people from delaying care.

Parkinson says healthcare doesn’t target the cost drivers or promote preventive care. To change that, employers and health plans must remove economic barriers (e.g., lowering or removing copays for evidence-based services), and assure that individuals are getting the proper testing, counseling, and immunization depending on their age, gender, and family history.

But it’s not just up to the doctor, health plan, or employer. The individual consumer also needs to take some responsibility. Patients must first think about behavior change when faced with a health problem such as chronic disease rather than turning to medication, says Parkinson.

This will mean an education campaign to teach healthcare consumers about how their health affects costs. He adds that the medical technology and doctor prescribing patterns have created a “medical euphoria in this country,” but the healthcare system must instead get back to the basics of prevention and wellness.

“We must educate all Americans about how behavior changes drive 75% to 85% of healthcare costs and determines whether they live long or well, and all the money spent on healthcare is their money,” says Parkinson.

One barrier to this movement is the way physicians are paid for care. In fact, there is only one healthcare stakeholder who benefits financially from prevention, says Dee W. Edington, PhD, director of the University of Michigan’s Health Management Research Center in Ann Arbor, MI.

“Our system now does not incentivize anyone to get preventive care except for the employer. The employer is the only one who benefits from healthy people,” says Edington.

—Les Masterson