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Busted: The Liberal Claim You're Too Stupid To Make Health Care Decisions

A new consumer survey from Deloitte’s Center for Health Solutions has already received a lot of attention for finding that only 30 percent of people are satisfied with their Obamacare coverage.

But the survey includes another important finding that undermines everything liberals have claimed about health care for years: The report claims that Americans are becoming better consumers in the health care marketplace.

For more than two decades there has been an ongoing ideological battle between conservatives who believe patients, in consultation with their doctors, can make good choices in the health care marketplace and liberals who are convinced that people are too stupid to make good decisions.

The “stupid” side will generally concede that consumers make choices in all other areas of the economy, but they will insist that “health care is different.”  That phrase is usually followed by a snarky comment about how patients can’t be informed health care consumers when they are being rushed into the emergency room—as if all of our health care decisions are made in an ambulance.

For example, in a 2011 post at Economists View entitled “Patients Are Not Consumers,” New York Times columnist Paul Krugman condescends:

“Medical care, after all, is an area in which crucial decisions—life and death decisions —must be made.  Yet making such decisions intelligently requires a vast amount of specialized knowledge.  Furthermore, those decisions often must be made under conditions in which the patient is incapacitated, under severe stress, or needs action immediately, with no time for discussion, let alone comparison shopping.”

Translation: Because the vast majority of you don’t have “specialized knowledge,” you can’t be trusted to make your own health care decisions.  And for most liberals that inability includes decisions about health insurance, which is why a single-payer system is supposed to solve your “stupid” problem.

But that claim raises the question: If patients can’t make their own decisions, who will make those decisions for them?

Why, a bureaucrat, or a panel of them—can you say Independent Patient Advisory Board (IPAB)?—who will determine what you can and can’t have.  Problem solved.

Fortunately, Deloitte’s “2015 Survey of US Health Care Consumers” comes to a different conclusion.

“Through this new buying experience, the exchanges are opening the door for a new generation of actively engaged consumers. … They are more cost-conscious, price-sensitive, and focused on finding a plan that offers good value and fit.  By the time they enroll, HIX [health insurance exchange] customers have a better understanding of plan benefits and costs than individuals with coverage through employers, Medicaid, or Medicare.  They are inclined to compare plans, providers, and services on price but show interest in quality measures, too.  These early signs suggest that HIX enrollees are becoming savvy, informed consumers who are geared to shop around not just for health insurance, but also for health care services and products.”

In other words, Americans are becoming value-conscious consumers of “health care services and products” as well as insurance.

There are still a number of challenges because price transparency, especially at clinics and hospitals, is still a work in progress.  But at least two factors are pushing reform:

  • Obamacare coverage is so expensive that it is pushing millions of people into very high-deductible health plans, and people who are paying out of pocket for care because of that high deductible tend to demand price information; and
  • More people are moving to Health Savings Account plans—covering about 17 million in 2014, up 12 percent from 2013—and they also tend to want to know prices.

And the real proof that consumers can make their own health care decisions comes from the National Bureau of Economic Research, whose March 2015 study found that employers that offered consumer driven health plans lowered their health costs, when compared to non-CDHP plans, in each of the three years studied.  According to the paper, “The reductions are driven by spending decreases in outpatient care, with no evidence of increases in emergency department or inpatient care.”

Isn’t that what Obamacare was supposed to do, but hasn’t?

Obamacare was set up by single-payer liberals who have never believed that people could make good health care choices.  And yet the expensive, convoluted system liberals created is forcing consumers and patients to do exactly what liberals said they couldn’t—and proving we don’t need a liberal minder to make our decisions for us.