Back to the future?

My mother always used to say, “What goes around, comes around.” I’m beginning to believe her, at least with regard to healthcare coverage.

Way back in the “dark ages” of the 1970s, when I began working professionally and was covered under employer-paid group insurance, healthcare (actually, sick care) was simpler: When I was sick, I went to the doctor. I paid the bill. I saved my receipts and eventually sent them to the insurance company.

Once my expenses hit a magic number (I think it was $100 or $250, which seems so little today — but remember, this was in the 1970s), the insurance company reimbursed 80 percent of my expenses. At least, that’s how I remember it working.

The problem with that system was that the insurance company only recognized expenses for sick care.

Enter managed care. The idea was good: Control costs through preventive care and cost-controlled procedures. But managed care got out of hand. Patients complained their insurance companies wouldn’t pay for necessary procedures. And doctors complained that managed-care organizations (MCOs) tied their hands.

MCOs are still tying the hands of doctors by second-guessing your work and by limiting reimbursements.

But that situation may be changing with a new type of healthcare coverage: consumer-directed healthcare (CDHC).

As Kevin Corcoran, the new executive vice president of the American Chiropractic Association, said, “[Consumer-driven healthcare] will function like the cash-basis system that was prevalent 20 years ago.”

So, it looks like we are heading back to the future — “What goes around, comes around.” The consumer will pay up front for healthcare expenses. The difference, of course, is that with CDHC, consumers can spend their healthcare dollars on staying well.

CDHC probably will not be “the” answer to our nation’s healthcare crisis. But it is a new concept to many people. Just as we needed to learn about managed care and what we could expect from it, consumers (and doctors) today need to learn about consumer-driven healthcare — and how it can benefit them.

I hope you’ll read our cover story. It explains more about CDHC and gives you some insights into how you can take the lead in helping consumers learn to spend their wellness dollars.

Until next time,

Linda Segall, Editor-in-Chief