Consumer-Directed Health Care: Promise and Performance

Jan. 27, 2009
Health Affairs, Web exclusive
James C. Robinson, Paul B. Ginsburg

"The performance of consumer-driven health care has fallen short of both the aspirations of its proponents and the fears of its critics," write James Robinson, the Kaiser Permanente Professor of Health Economics at the University of California, Berkeley, and Paul Ginsburg, president of the Center for Studying Health System Change (HSC), in a Web-exclusive article published by Health Affairs. Growth of the organizational forms favored by advocates of consumer-driven health care, such as high-deductible health plans and individually purchased insurance, has been "anemic," the authors note.

Robinson and Ginsburg argue that the insurance market "has merged the ideas of consumer-driven health care with those of managed care instead of replacing the latter by the former." They point out that today's dominant form of insurance, the preferred provider organization, "combines network principles from managed care with some of the cost-sharing principles from consumer-driven health care."

Free access to this article is available at the Health Affairs Web site by clicking here. (Free access until Jan. 28, 2009.)