To fully navigate your marketplace choices, you also need to rev up other behaviors. Part of the personal responsibility mantra means being assertive and engaged in your purchasing activities. So how do you switch from being a passive consumer to becoming an active, assertive, smart consumer? Here are some suggestions:
Just as we need to be smart about our purchases, we need to be particularly informed about purchasing and managing our health care. Current trends in health coverage and care are mirroring personal financial management trends by following the consumer "accountability model." That means you can expect to increasingly face the requirement by health care providers that you participate responsibly in your own care. You should also expect to absorb at least part of the spiraling costs of health care as well.
In the old model, most working Americans were provided employer- or union-sponsored health insurance as an earned benefit. Employees picked their doctors and depended upon them to tend to the health care needs of their families. The health insurance company paid the doctor bills, and if hospitalization was needed, it paid for hospital care as well. Hospitals usually were community-based or university sponsored, and most were operated on a nonprofit basis. In striking contrast, the health care field today - from doctors to hospitals, to pharmaceutical companies, to health financial corporations, to consultants, to Wall Street - is big business. It got that way over many years, and our nation should have prepared better for the costs and complexity in human and social terms of what was to come.
Today, those of you who are still fortunate enough to have sponsored health care coverage, but also those of you who are not, are nevertheless all "consumers of health care." As consumers, you must be savvy enough to pick the health plan that is right for you if it is offered and to incorporate health care into your financial planning. If you do not understand your plan, you must pester your employer or union or coverage provider until you do; if you are uninsured and unable to obtain coverage for whatever reason, you must pester your politicians to change your access to health care.
The new health care models are called "consumer-driven health care," and theoretically, they are founded upon sound principles. The nation's employers, their consultants, and the health care industry "burned out" from the consumer backlash over health maintenance organizations (HMOs). So, they created consumer-driven health care (called CDHC for short) to give us more choice about who provides and coordinates our care and what our care will consist of. The newer plans are less structured and more varied, giving us more choices but also requiring more payment responsibility from us. These health benefits models anticipate that if we pay our own health care bills or a large part of them anyway, we will make healthier choices: not to smoke, not to abuse alcohol, to choose healthful meals, and to exercise regularly. Our healthier choices, goes the theory, will result in savings - for us, for our employers, and for the health care industry - because we will not use so much health care. As consumers, we will naturally need less health care and be rewarded by paying less for the care we consume. Our employers and the health care industry, meanwhile, can then cap their out-ofcontrol health care expenses. They will also have an easier time continuing to generate the profits that Wall Street and their investors expect to remain competitive in a global economy.
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