Big lies about consumer-driven health care: The John Torinus and KI edition

John Torinus -- WMC board member, Serigraph chairman, Milwaukee Journal Sentinel business columnist -- and other "free market" health care reformers like Leah Vukmir loves them that word "consumer" when it comes to health care.

Consumer-driven.

Consumer-empowered.

Consumerism.

In the Torinus world, consumers -- who will know how the cost of their desired medical procedures and who will have the freedom (and time! and savvy!) to comparison shop among different providers -- are the ones who will lead us into a New Jerusalem of lower cost health care.

In a July column, Torinus looked to KI, a Green Bay manufacturer, to offer us a glimpse of this utopia:

KI in Green Bay is one more data point in why the top-down state Senate plan for universal health care in Wisconsin does not compute.

KI is arguably the place to benchmark in the private sector for best practices on simultaneously delivering health care and controlling health costs. Its self-insured plan offers a full set of benefits, stresses wellness, prevention and fitness and brings it in for less than $6,000 per employee....

As a KI director, I have had the chance to see its results from installing a consumer-empowerment plan. Its incentives prompt judicious behavior by its workers in how they use and purchase medical treatments, in their lifestyles and in following disease regimens.

KI's benefit plan is well regarded by its 1,429 covered people, and its price to employer and employee is near the lowest in the state for a full plan. The price tag for KI and its workers came to $8.8 million in 2006.

Weirdly, his column in the Journal Sentinel left out some information that Torinus shared with executives gathered at an April 2005 breakfast in Pewaukee sponsored by the Advanced Manufacturing Network Southeast, Waukesha County Technical College and the Waukesha County Economic Development Corporation. From a topline overview of his presentation:

K.I. in Green Bay has a similar plan to Serigraph’s and it rates its employees’ health A-D through the health risk assessments.

• The A-rated employees (best health) are going to pay a very low premium.
• The D-rated employee  (poor health) will pay an increased premium.

Here's a tip: When you want to learn the real deal about a business initiative, don't pay attention to what executives tell the hoi polloi. Pay attention to what executives tell each other.

And the Brawler would suggest that there is nothing, absolutely nothing, "empowering" about being an employee with a D rating.

Not only are the less healthy getting hit up for the extra services they actually use through the high deductible and other cost sharing --  they're also getting hit for the extra services the insurance company assumes they'll use due to their risk level.

Feel that consumer power!

(And yes, the argument that "consumerism" will lead to lower prices is laughable. For some procedures, such as lasic eye surgery, sure. But the big ticket items, such as chronic care and major or emergency surgeries, don't lend themselves to comparison shopping. And someone please explain how a hospital can go about establishing itself as the low-cost provider for triple bypass surgeries.)

John -- just call it employer-driven health care and try to sell it that way!