Americans Prefer Employer-Selected Health Coverage

September 22, 2005 08:55:49 AM PST
Americans would much rather choose a health plan from a set of options their employers select than to be given an employer-funded account to purchase their own plan, a new study shows.

Two-thirds of adults surveyed preferred having employers choose health plan options, with majorities of both Democrats and Republicans supporting that approach.

The study, released Thursday by the Commonwealth Fund, also revealed that people care more about being able to choose their own doctors than having a choice of health plans.

"What we're finding is that whatever way you cut it, it looks like the type of choices that people prefer are about health-care providers, not about health-care plans, and they're not so eager to abandon the employer-based system," said study author Jeanne M. Lambrew, associate professor of health policy at George Washington University in Washington, D.C.

The findings call into question whether policymakers ought to be pushing health savings accounts as a way to reduce health costs and give people more control over how they spend their health-care dollars. Lambrew's analysis suggests it may not be what most people want.

"We saw a public backlash against very closed HMOs in the 1990s," she recalled. "We may see a similar backlash against these types of policies given the fact that people may not want them, and they prefer a type of system in which we still have employers involved in making these decisions."

Greg Scandlen, founder of a newly formed grassroots lobbying organization called Consumers for Health Care Choices, argued that this interpretation is flawed. "This is looking at things the way politicians look at things," he said. "They're looking for 50-plus percent support of an idea, which is not the way markets work."

This survey found that one-third of the people prefer choosing their own health plans, he added, "and one-third of the market is huge."

Currently, more than 1 million Americans receive health care through a high-deductible plan paired with a health savings account, or HSA, according to a study by America's Health Insurance Plans.

An HSA is a relatively new type of investment account. It gives people a tax-free way to save for medical expenses. Contributions to the HSA may be carried over year-to-year to pay for future medical care. Or, the account holder may withdraw funds as needed to cover current expenses, including doctor and hospital bills, prescription drugs and over-the-counter medications.

President Bush has endorsed HSAs as a way of reigning in the rising cost of health care in the United States. But critics of this approach worry that it will erode the current employer-based system of health insurance.

Using data from the Commonwealth Fund's own biennial health insurance survey, Lambrew examined whether people really want more choice and control over their health plan options, as HSA proponents insist. The survey captures data from a nationally representative sample of 3,293 working-age adults.

The data suggest people value provider choice more highly than health plan choice. About 12 percent of those with only one health plan -- offering, in other words, no other choice of plan -- were likely to be dissatisfied with their health care. On the other hand, the dissatisfaction rate was more than twice as great (26 percent) among those individuals given no choice as to which provider to go to for their care.

Additionally, 67 percent of people who had no choice of where to go for their care indicated that a choice of health plans is very important. That compares with 55 of those given lots of provider choices by their plan. In contrast, just 37 percent of people restricted to one choice of health plan deemed having multiple health plan choices as very important.

"So, ironically, the people with no choice of plan didn't really feel like it was a problem," Lambrew said. "But the people who have very limited choice of doctors did feel like if they could just have more choices, they could get out of this box."

Based on these new findings, Lambrew urged policymakers to "think twice" about moving away from the traditional employer-based system.

Scandlen, however, doesn't think policymakers should bet on any single approach. "I don't think everyone should be in an HSA plan," he said. "Some people prefer HMOs, and they should be able to do that, too."

More information

For more on employer-sponsored health insurance, visit the Agency for Healthcare Research and Quality. To find out about health savings accounts, see The HSA Insider.

Health Highlights: Sept. 22, 2005

September 22, 2005 08:41:11 PM PST

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Guidant Recalls Additional Pacemaker Models

Guidant Corp., which has already recalled or issued warnings about more than 100,000 implantable defibrillators and pacemakers, on Thursday said it was recalling two more models of pacemaker: the Insignia and Nexus, the Associated Press reported.

The 36 documented failures involving the newly recalled models include nine cases requiring emergency hospitalization. Guidant said these models might be at risk of permanently losing pacing output without warning, the AP said. No deaths have been connected to the latest recalls, which also were prompted by the appearance of a reset warning message in some cases.

Guidant also announced that the failure rate for two defibrillators recalled earlier -- the Contak Renewal and Contak Renewal 2 -- was nearly triple the company's previous estimate, the wire service reported. In June, Indianapolis-based Guidant recalled 88,000 heart defibrillators and issued warnings about 28,000 pacemakers.

Guidant spokesman Dave Knutson said the latest recalls stemmed from a nearly two-week inspection by the U.S. Food and Drug Administration that ended on Sept. 1 at the company's St. Paul, Minn., plant. The FDA requested five years' worth of documents during the investigation, the company spokesman added.

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Cancer Drug Approved in Europe

The Roche anti-cancer drug Tarceva, already approved to treat lung cancer in the United States, has been approved for the same use by the European Medicines Agency, the Times of London reported Thursday.

The U.S. Food and Drug Administration approved Tarceva in November 2004 for use in advanced non-small cell lung cancer cases. The agency is now debating whether to OK it for a second use -- as a treatment for pancreatic cancer, the New York newspaper Newsday reported.

On Friday, the agency's oncologic drugs advisory committee will decide whether to recommend full agency approval for the combination of Tarceva and chemotherapy as a way to extend pancreatic patients' lives.

In clinical trials, median survival in Tarceva patients was 6.4 months, compared with 5.9 months among pancreatic cancer patients who didn't take the drug, Newsday said.

In other news from Europe, Procter & Gamble has unveiled a nasal spray that it claims will reduce a person's chances of developing a full-blown cold by up to 50 percent if taken at the first sign of symptoms, the Times of London reported. Called "First Defense," it is a non-drug gel that is said to dissuade viruses from infecting the body's cells, the newspaper said.

P&G wouldn't say whether it plans to market the product in the United States, U.S. newspapers reported.

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3 Baby Deaths Show Staph Germ Is Strengthening: Report

A baby and two toddlers in the Chicago area have died from a superbug they caught in the community, not in a hospital, which is where the germ is usually found, case reports released Thursday reveal.

The cases show that the staph germ, known as methicillin-resistant staphylococcus aureus, or MRSA, has become even more dangerous by acquiring the ability to cause a deadly illness similar to toxic shock syndrome, the Associated Press reported.

In the cases, reported in Thursday's New England Journal of Medicine, the three children who died were otherwise healthy before they were separately admitted to a Chicago hospital with pneumonia-like symptoms between 2000 and 2004. The babies -- a 9-month-old girl, a 15-month-old girl, and a 17-month-old boy -- died within a week of being hospitalized. Autopsies showed they suffered from shock and bleeding in the adrenal gland. The infections were caused by MRSA, which is usually not associated with the syndrome. Doctors believe the children probably inhaled the germ, the AP said.

Health officials do not yet know how the staph infection causes this new syndrome, but it appears to be rare, according to Dr. Clifford McDonald, an epidemiologist with the federal Centers for Disease Control and Prevention. However, doctors should be on the lookout for shock-like cases caused by MRSA, said Dr. Robert Daum, a pediatrician at the University of Chicago, who co-authored the study.

In April, the journal had reported strong signs of the staph infection moving out of hospitals into communities.

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Kids' Costume Jewelry Recalled for Lead Hazard

Monogram International Inc. is recalling 145,000 Disney Princess Bracelet Keyrings, which contain high levels of lead that could be toxic to young children, the U.S. Consumer Product Safety Commission said in a statement issued Thursday. No injuries have been reported. The products, made in China, were sold at retailers nationwide including Wal-Mart and Walgreen's from November 2003 through June 2005 for about $3. Consumers should take them away from children immediately, and contact Monogram at 1-800-736-1941 between 9 a.m. and 5 p.m. ET Monday through Friday for more information.

Separately, the CPSC announced that Dollar General Stores is recalling 455,000 children's necklace and earring sets that also may contain hazardous levels of lead. No injuries have been cited involving this recall. The products, also imported from China, were sold at Dollar General Stores across the United States from May through August 2005 for between $1 and $3. Take the products away from children immediately, and contact Dollar General at 1-800-678-9258 between 9 a.m. and 6 p.m. ET Monday through Friday for more information.

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Coretta Scott King Released From Hospital After Stroke

Coretta Scott King was released Thursday from an Atlanta hospital more than a month after suffering a stroke and a mild heart attack, the Associated Press reported.

The 78-year-old widow of slain civil-rights leader Martin Luther King Jr. had been recovering at Piedmont Hospital since Aug. 16. She has made a partial recovery from the stroke, which initially left her unable to speak or move her right side, the wire service said.

She undergoes three hours of daily therapy and has regained some speech, the AP said.