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Individual Health Insurance Markets That Work, Part Two

Jacqueline Fellows, for HealthLeaders Media, November 20, 2013

So, in Australia, when patients go to the hospital, they [are given] an estimate of what the bill might be at the end, and it is signed just like informed consent. When we talk about consumer empowerment, to me this is a great example. You could do this on a small scale or a big scale, but the idea is right.

They also involve the Australian Medical Association, and put out communication for consumers, such as checklists for what a patient might ask the doctor or the insurance company. They're training consumers as patients in healthcare financial literacy.

In the U.S. we have been somewhat reluctant to engage in [that] until relatively recently. Now that so many more Americans are in high deductible plans or paying out of pocket before insurance kicks in, we need to catch up with some basic framework [for] how to talk about it. You don't buy a car or a house without asking questions. That was one example that I thought we could learn from, and that it tactical and tangible for our industry.

HLM: Some organizations are pushing that idea through revenue cycle strategies. What is the resistance?

Gordon: For a thousand reasons, it's hard. It's hard to estimate cost. The prices differ depending on the deal the provider has with insurance company.

If consumers start to push, if health plans and providers start to encourage that push and prepare to respond, we will figure it out. We'll only figure out the hard things if we have to. We've got a lot of challenges, but we may not willingly take on the next big challenge without a push or a without a model that shows it can be effective.

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