NCPA - National Center for Policy Analysis

How Much Choice In Health-Care Plans?

March 6, 2000

Many health maintenance organizations offer a "point of service" plan option that allows patients to pay more to see a doctor outside the HMO's network. But critics say most consumers still don't have any real choice. That's because their employers often pick which health plan they will offer.

The Commonwealth Fund has come up with some data on this issue.

  • Thirteen percent of workers say their employers offer them no health coverage, while 38 percent report that they are offered only one health plan.
  • Yet 42 percent are presented with two or more plan options.
  • Four out of every 10 employees who switched health plans did so because they changed jobs, while 24 percent claim their employer switched to another plan
  • Thirteen percent switched because their eligibility was changed, and another 11 percent did so because they preferred another plan.

Health-care reformers argue that employees will not have a true choice until they are given the responsibility of selecting their own plans. Under this model, the employer would provide a set amount of funds for insurance coverage, which the employee could supplement with his own funds if he wanted to purchase a more inclusive policy.

A few large U.S. companies have already taken this route and others are studying it.

Source: Editorial, "Industry's Vision of HMO Choice Falls Short of Patient Needs," USA Today, March 6, 2000.


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