Bioethics Blogs

More on 3.0

Here is a nice follow-up story on my recent New England Journal article on improving the design of health insurance exchanges.

Comparing health insurance plans – whether signing up through or weighing employer-sponsored plans with a spouse – can feel like wading through a sea of information on deductibles, co-payments and monthly premiums. Now that more than 11 million people have chosen a plan during this year’s enrollment period, which ended on Feb. 15, three experts are pondering how to make this intimidating task even easier for next year’s registrants? They have laid out their prescription for improving the health insurance marketplace, grounded in psychology and behavioral research, in a perspective published Wednesday in the New England Journal of Medicine.

“This is a really complicated decision to make and a pretty high-stakes one, too — it can mean a lot of money,” Peter Ubel, a co-author and health marketing expert at Duke University, says. “I think a better designed system would actually be faster to go through and yet still help you make a better decision.”

In the existing marketplace, the authors don’t like the way plans are sorted into gold, silver and bronze categories.They think these labels make the gold plans inherently more desirable. The team did a preliminary test of this theory by presenting a choice of two plans to public bus riders in North Carolina – one offering lower monthly premiums but higher out-of-pocket costs than the other – and alternately labeled them “gold” and “bronze.” Inevitably, more than half of riders chose the “gold” plan, no matter if it had the higher or lower premiums and deductibles.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.