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January 30, 2006

If you’re going to do it, do it right:
Univ. of Michigan experts available to comment on Pres. Bush’s State of the Union health care proposal

Any cash-based changes must include provisions for preventive care, they say

A. Mark Fendrick, M.D.

ANN ARBOR, Mich. — University of Michigan researchers who have studied the impact of out-of-pocket health costs on Americans’ behavior are available to comment on new ‘consumer-driven health care’ proposals that President George W. Bush is expected to unveil in his State of the Union address on Tuesday evening.

While the details of those plans are not known, they are expected to involve more emphasis on individual cash accounts and cash expenditures for health care, in exchange for tax breaks or other incentives.

If so, the researchers say, any plan to increase the consumer’s role in health spending must also include a way to ensure that consumers get essential, proven preventive care for little or no money of their own.

These include medications and tests that have been proven to save money in the long run, by preventing the progression of problems or spotting them early. They include screening high-risk individuals for cancer, cholesterol-lowering drugs for people who have survived a heart attack, vaccines for children, and certain medicines and tests for people with diabetes mellitus.

Research at U-M and elsewhere has shown that the more money people have to pay out of their own pockets to get such care, the less likely they are to actually take the medicines or have the tests done. And that increases the risk of more expensive — and preventable — problems down the road.

“Involving consumers in making their own health care spending decisions is important and will likely save money at least in the short term,” says  A. Mark Fendrick, M.D., co-director of the U-M’s Center for Value Based Insurance Design and a professor in the U-M Medical School and U-M School of Public Health. “But most of the discussion regarding consumer-directed health plans fails to address the fact that increasing out-of-pocket expenditures will lead to decreased utilization of essential health care services. We need to create a system that will remove financial barriers for those clinical services where there is clear evidence of value.”

Fendrick, along with fellow researchers Michael Chernew, Ph.D., John Piette, Ph.D., and Allison Rosen, M.D., MPH, Sc.D., of the U-M Medical School and U-M School of Public Health have all studied how people change their medicine-taking habits and other health behaviors depending on how much cash they have to pay.

For more on their research, or to reach them for comment, call 734-764-2220.

For more information on relevant research by these U-M experts and others, see these press releases:

Read a related editorial by Dr. Fendrick and Prof. Chernew in the latest issue of the American Journal of Managed care, here

Are some medicines so good they should be free? In diabetes, U-M study finds, the answer can be yes

Study: The higher the co-pay, the lower the chance that heart patients stay on cholesterol-lowering drugs

Your money or your health: U-M/VA study yields first proof that cutting back on prescriptions due to cost linked to worse health later

Many patients don’t tell their doctors they’re cutting back on Rx medicines to reduce costs, study finds

One in six older adults with chronic ailments skip Rx drugs because of cost, VA/U-M study finds

Study: Diabetes patients skip medications to save money

U-M team offers Rx for drug dilemmas: tailor the copayment to the patient

Written by Kara Gavin  

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