Chapter 3 The Consumer Experience and American Health Care: Four Scenarios

This paper offers a conceptualization of two dimensions of health care markets in the US, their interaction, and implications of that interaction. The combination of the amount of consumer out-of-pocket financial responsibility and the level of information available to consumers about services and pricing (along with accompanying potential decision-making empowerment) may well determine the way in which health care consumers will interact with health insurers and providers for many years to come. This paper presents a way to model the interaction of these dimensions. The interaction yields four possible future scenarios for health care in the US. These scenarios, in turn, can assist the major stakeholders in the health care system in what may well prove to be fate-making decisions. Finally, different scenarios suggest different entrepreneurial activity.