Health Insurers Must Be Cautious With Plans To Shift Costs to Consumers, Sacramento Bee Says

In response to rising health care costs, HMOs are "busily reinventing themselves," but that is not always a "healthy thing," according to a Sacramento Bee editorial. Underlying the trend is an effort to shift the "unsettling realities of medicine on a budget to consumers," the editorial contends. For example, Kaiser Permanente, California's largest HMO, has attempted to "whittle down" benefits, including prescription drug coverage. The insurer also proposed a health plan that would limit prescription drug coverage to $500 per year, but the plan was rejected by the state Department of Managed Health Care. While some people might consider such a limited plan "better than none," the editorial says the Kaiser plan was "so limited" it was not worth purchasing. On the other hand, PacifiCare has a new product that is a "good idea" and "worth trying out," the editorial says. Called the "value network," the plan limits patients to a narrow list of doctors and hospitals that were selected based on cost and quality standards. The editorial concludes that as the "painful process" of shifting costs to patients continues, "neither regulators nor the industry can forget the underlying purpose of insurance. It is to insure the patient, not the insurer, particularly when the patient needs insurance the most" (Sacramento Bee, 10/17).