Even if employees were motivated to get more involved in health care coverage decisions, and even if they had the know-how to weigh all the variables before making those decisions — two big ifs — they would not have access to the sort of informa-tion that they'd need to pull this off, says a report by the Employment Policy Foundation, an organization that studies workplace trends.
"A lack of transparency in health care prices and the absence of reliable data on quality of care for each health care provider make it difficult for consumers to make adequate health care choices," the EPF says in its report "The American Workplace 2005."
That's a sobering assessment in an era where the consumer is king, or a pawn, depending on whether you view the push for consumer-directed health care as an empowerment tool or as a ruse to shift more of the financial burden onto patients.
The EPF findings are echoed in an article in the Sept. 8 edition of the Wall Street Journal that finds that consumers who shop around in, for instance, New York City, can wind up paying anywhere from $400 to more than $1,500 for an MRI. For mammograms, the price ranges from $50 to $300. True, the Journal was able to get a price quote without much trouble, usually in a phone call lasting no more than five minutes.
"But the bad news is that we didn't always get accurate information," the paper reports. "When we called New York University Medical Center, a person in the billing department told us the rate for an MRI was $2,000. But when we called the medical center again, this time as a reporter to get a comment about the price, it gave us a different figure: $1,100."
These sorts of findings point to possible problems with health savings accounts, one of the linchpins of the Bush administration's effort to change the system. Under HSAs, enrollees may set aside money tax-free, either individually or through joint contributions with employers.
Any unused portion may be rolled over from year-to-year, and the accounts are entirely portable as well. Members may take their HSAs from job to job, just as they would a 401(k).
EPF President Janemarie Mulvey warns that if the purpose of HSAs is to make consumers more savvy about health care purchases, then a better foundation may be needed.