Since the new San Francisco Health Access plan, approved in July, only covers preventive and catastrophic care, everyone who
will receive coverage still needs to learn how to become an astute buyer, according to Chini Krishnan, founder and CEO of
Healthia Inc., an integrated comparison-shopping portal for healthcare products and services, headquartered in Mountain View,
Calif.
"People still need to learn how to shop for routine medical care effectively, and part of that education might be the realization
that a high-deductible/HSA plan might be a better deal for them than the San Francisco offering," Krishnan says. "Public and
private sectors must work in tandem to ensure consumer empowerment and the introduction of architecturally sound products
and services."
However, Krishnan says, for people who are otherwise uninsurable—especially those with serious pre-existing health conditions—this
plan might be a good way to get them covered and reduce the municipality's overall healthcare expenditure, especially if it
can reduce emergency room visits. "But for low- and middle-income relatively healthy individuals, this might not be the best
use of taxpayers' money. Lots of carriers list plans ... that offer better coverage and service at a comparable monthly premium,"
he says.
Krishnan says that he is reminded of the Medicare HMO roll-out. "Many were banking on its success, but it did not deliver
on its promises for all stakeholders," he says. "It's important to remember that the marketplace determines outcome; a universal
healthcare model has to withstand serious scrutiny and assessment. The model has to make good fiscal sense for all." Managed care programs will need to give consumers the tools they need to make informed decisions and use their coverage dollars
wisely, he says. "The devil will clearly be in the details, since every geographic locale is likely to offer up different
options," Krishnan says. "In a way, this is a challenge for managed care providers: For them, this is another product offering
with which to compete. It will be up to executive leaders to decide how much they really want to play in this sandbox and
with whom they choose to play."
