Can Consumers Fix the Health Care System

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Can Consumers Fix the Health Care System?

• Fred Moore - Executive Vice President

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My Answer Not Without Our Help

• A US Perspective

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Consumer Behavior Determined By

• Their situation
• What they want
• Their habits
• Their financial capacity

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What is Their Situation?

• People are living longer
• With more and more chronic diseases
• People understand the benefits of medical
  technological advances
• We all know someone who 10 years ago would have
  died but in 2005 wont (with only 150,000 of
  medical treatment)
• We all know someone who enjoys life more because
  conditions are treatable, survivable
• Prescription drugs demanded and used more often
• Direct to consumer advertising
• The search for the magic pill

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What Do They Want?

• All the quality medical care someone else will
  pay for
• A third-party payor
• The government
• Their employer
• To live longer, healthier and happier
• Lower risk, pain and inconvenience

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What are Their Habits?

• Sedentary lifestyle
• Bad diet and super sizing meals
• Tobacco use
• Little knowledge of the true cost of health care
• Dependent on third-party payment

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What are Their Means?

• Changing household incomes
• Rising among baby boomers (ages 45-60) with
  emerging chronic diseases and empty nests
• Flat among generation X (ages 30-45) full-nest
  households
• Little or no money intentionally allocated to
  health care

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How Do We Turn Patients Into Consumers?

• Create awareness
• Provide management and financial tools
• Create partnership with employees and employers
  in health care use and financing
• Demonstrate total value employees receive for
  benefits
• Use member-responsible plan designs
• Channel health care purchasing to more efficient
  higher-quality provider organizations (not just
  low unit prices)

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Coverage, Cash, Care

• High deductible health plan provides coverage
• Health savings accounts provide tool to
  consciously allocate consumer money to health
  care with investment options
• Disease management and health/wellness programs
  help consumers become active participants in
  their health care
• Information resources provide tools for health
  care purchase decisions

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Does It Work?

• Wausau Benefits had flat trend in a year when
  national average was 15 cost increase
• Persistent disease management program
• Tiered networks with strong incentive to use more
  efficient (and higher quality) health care
  organizations
• Consumer-driven financial tools

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Does Consumer Driven Health Care Work?

• Yes!
• With Our Help!

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