To pcervieri:

Thanks for the reply. I would like to go further becasue you seemed to just skim over the critical part of my previous questions. If large payers can NOW already get 60% off the supposed provider charge, I would think that would be the best individual consumers could ever hope to get, so if it is already available with large payers, WHAT EXACTLY IS THE ADVANTAGE PRICE-WISE for the caveat emptor, individual shopping around in healthcare?????

As for assessing quality, I fail to see again why caveat emptor should be the preferred method of judging quality in a supposedly state regulated system. What the heck is the regulation for if consumers have to figure it out on their own?? I would think all quality should be guaranteed by the system through accountavility to experts, as that is the point of licensing and state boards,no? Besides, consumers on their own will never overcome the info asymmetry and emotional stress between them and providers, never!!

So we are back again to the question of lowest price, which I believe I have already shown is best set (that lowest price) by large payers. The absolute best and fairest example of that would be a monopsony of a single payer negotiation, IMO!

so i think the point is that prices may be higher now, but going forward they will drop when all these pressures start to act against providers (unruly consumers and 3rd party information providers – the health care equivalent of priceline).

here is an interesting talk on the future of consumer directed health plans:

http://www.scribemedia.org/2006/12/09/regina-herzlinger/

peter
ScribeMedia.org

With respect to what prices you are charged by providers when in the
deductible part, I want to know if the prices charged in consumer directed
plans are the insurance allowable prices even when you pay from your HSA
account, or whether you have to just meet the provider charge as given until
the insurance kicks in. I say this because few people will have the
economic clout and knowledge to judge what a good price is as compared to a
giant insurance company that has the clout and expertise to know and set
good rates.

I am constantly amazed when I get my insurance statement (EOB) to see how
much of the original provider charges are not allowed and do get written
off. It usually approaches 60%, and I thank God I have the insurance
company showing me what a good rate is. I could never know that by myself.
Hell, if the uninsured could just be given the insurance companies fee
charges, that alone would save them 60%!

I want to know if the part that is paid from the consumer-directed account
is paid out by you (your account) at the full provider charges, or whether
it is paid by you (your account) at the insurance company ALLOWABLE rate??
If paid out at the insurance allowable charge then 2 more questions:

1. What makes the provider take this fee schedule when you are suppose to be
able to shop around?

2. What are you really shopping for if the insurance company is then setting
the price you are charged?????