Behavior change may very well be one of the keys to true health care reform. Given the proper market environment, American consumers will respond accordingly and adapt.

For example, we have reduced our debt to disposable income significantly over the last several years in response to the economic environment. But behavior change is hard - tried dieting, a new exercise regimen, or quitting smoking? One area of potential behavior change is how we, as consumers, utilize our health insurance. I'm a consumer too and the following is a personal example that I believe highlights an area for behavioral change.


Creature of habit

Through my company I am currently enrolled in a "low" deductible health plan - not a CDHP or HDHP -with a health savings account. I had already met my deductible and had a zero balance on my flexible spending account when my doctor recommended a colonoscopy, which seemed like a reasonable thing to do given that it had been nine years since my last one.

The doctor was recommended by a friend and is affiliated with a hospital. She had helped resolve a longstanding issue and I was pleased with the results. I mention my friend's recommendation because that is one way to address quality of care concerns many consumers have.

So herein lies the problem. Unlike many health care consumers, I knew that the cost of the facility my doctor uses (a hospital) is much more expensive than alternatives. I also knew that my insurance company would cover the procedure at 100% regardless of where I had it done.

So, despite my foreknowledge, I did what almost all health care consumers do - I took the path of least resistance, got the procedure done at the hospital without further thought and got on with my life (good results from the colonoscopy, by the way).


The right environment

So what does that make me? Lazy? Apathetic? A lemming, perhaps? At a minimum it makes me part of the problem. However, like most consumers I have a good idea of what I'm going to pay for something, particularly if it costs thousands of dollars. I research. I consult friends and family. I Google. I bought my last car using the Internet service available from the dealer. Got the color, options and price I wanted. Manufactured in Tennessee.

So why not my health care? Probably because I've been in employer-sponsored plans for as long as I can remember. This is how I have been "trained;" it is what I am accustomed to.

I don't think I have ever asked a doctor what a procedure is going to cost. At least not for services covered by insurance. Providers of services like Lasik or cosmetic surgery are very cost competitive - they even provide proposals.

Furthermore, over time, the technology for both of these services has gotten significantly better, while the costs have gone down. Kind of like smartphones, tablets and pad devices.

So if we're going to change the behavior of consumers we need to set up market environments that will facilitate that change. There is already some good work being done by the many experts in our industry. Now is the time for us to roll up our sleeves and do the heavy lifting.

Lamb is VP and group head of the EbixBenergy business unit at Ebix Health in Atlanta. Reach him at

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