title: Rearranging the deck chairs.
abstract: In their efforts to make insurance premiums more affordable, employers and health plans are promoting consumer-directed health care as a consumer-friendly alternative that will cut costs and improve quality. In my view, consumer-directed care reflects health care providers' failure to deliver value and unrealistically assumes that consumers can make sound, cost-effective medical decisions. It also evades the fundamental question of how society defines the limits and obligations of health insurance, and it could stall meaningful action to hold all stakeholders accountable for an equitable, high-quality, and affordable system.
authors.affiliation: Sacramento Healthcare Decisions, Rancho Cordova, California, USA. ginsburg@sacdecisions.org
authors.forename: Marjorie
authors.initials: M
authors.lastname: Ginsburg
mesh_terms: D001294:Attitude to Health; D003258:Consumer Behavior / Q000191:economics*; D005249:Fees and Charges; D020793:Gatekeeping; D006264:Health Benefit Plans, Employee; D006801:Humans; D020402:Medical Savings Accounts; D010358:Patient Participation; D012941:Social Responsibility; D014481:United States