Consumerism is the theory that if individuals control their own health care spending it will get better and cheaper. In practice it has resulted in the high- deductible health programs. People enrolled in these have high deductibles in which they pay out of pocket until their coverage kicks in.
Imagine that instead of a copay for a medical visit, you pay a percentage of the total until you hit your deductible. This manifests itself in two ways: 1. High-deductible plans with an employer subsidy to a tax advantaged or other account to offset the increased deductible. 2. Plans that just flat out cost more for the consumer and less for whoever is paying the premium. Under an individual mandate I can see more of 2, but I would expect 1 to vanish entirely. This is mostly because I expect groups (which are primarily employers at the moment) to fade away.
This is actually a shame because having health care businesses which could ethically incent people to do things which could improve their health could be a good thing. There's a couple ways it could be done even in a single-payer system, but it would take a regulatory framework that is good at managing for the long-term. And in case you missed the recent financial debacle, let me assure you, we don't have demonstrated expertise in that area to draw on.
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