It has been always mentioned here that our healthcare system can only be saved if patients have some skin in the game. Mainly that means taking care of themselves (eating right, exercising, not drinking or smoking, etc). Another definition is when they pay for their own healthcare out of their own pockets and subsequently eliminate third parties except for catastrophic care. This a cash-pay or a direct-pay model. Still another definition is for employers to allow their workers to pick the insurance products they want understanding that they may have higher deductibles, etc. In other words, they could pay less yearly but would take the risk of more coming out of their pockets. This was just illustrated in an article in the WSJ and guess what? When people spend their own money they tend to be cheaper. The example included “employer-centric marketplaces, known as private exchanges, are separate from the public exchanges created by the federal health overhaul law, which will be set up by state and federal governments. However, the public exchanges, serving individual consumers and small businesses, will operate on a similar principle of allowing people to shop for health coverage in an online marketplace.” In other words, most people are going to go cheap once these public exchanges are available as well. What this means is anyone’s guess. Will people stop using doctors as much because more is coming out of their pocket? Probably. Will this open up opportunities for direct pay models? I don’t know the answer to that. I only know that since Medicaid patients still have no skin in the game, they will be crowding the ER as much as ever.
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