Most people with health insurance, especially employer paid health insurance, really don’t know what their health care costs are. Furthermore, in many cases, they are limited in which health providers (doctors, hospitals, pharmacies etc) they can use.
Most people are locked into a network of doctors. They know what the co-pay is, but have no idea what the doctor actually charges.
When insured consumers are hospitalized, they rarely see the bill. They don’t know if the insurance company was overcharged or not. There are firms that audit hospital bills for insurers and self insured companies. They get paid a percentage of what they save on the bill payer by finding overcharges, duplicate charges and the like. The last I heard these firms were still making lots of money.
Overcharging, whether deliberate or not, by doctors and hospitals drive up health care costs for all. (So do malpractice suits, but that’s another story.)
In order to give consumers more direct control not only over their health costs, but in the choice of which doctor they can see or which hospital they can enter, Congress enacted the Health Savings Account Availability Act. As of the beginning of 2004, individuals who are not otherwise insured can have Health Savings Accounts (HSA) , which carry with them some very attractive tax benefits.
An individual can set up an HSA for himself or his family. An employer can add an HSA option to the so-called cafeteria benefit plan it may already offer.