What employees think about consumer-directed health plans

Vishal Agrawal, Paul D. Mango, and Kimberly O. Packard:

Eager to curb the rising cost of health care, many US insurers and employers are considering consumer-directed health plans (CDHPs), which are designed to lower costs by giving consumers more responsibility for managing their own health care spending.1 Indeed, a survey indicates that this interest is more than justified. We found that the plans encourage value-conscious behavior, increase the consumers’ level of engagement with their well-being, and may even promote behavior that leads to better long-term health.

In March 2005 we surveyed 2,500 consumers, 1,000 of whom had been enrolled in a CDHP for at least one year.2 We also conducted extensive interviews with 25 of these CDHP consumers and with seven benefits managers who administer the plans.3 Our goal was to learn how consumers’ behavior changes when they become responsible for a greater share of their health care costs.

Newspapers as Mainframes


Jeff Jarvis and others have been discussing the analogy of newspapers as mainframe computers. In essence, they are analagous: mainframes represented centralized processing, distribution and control. PC’s came along and blew that up. Mainframes still exist, but are being replaced by clusters of smaller, generally clustered linux computers. The migration continues to ever smaller network devices.

There is another analogy: Newspapers as legacy media. I recall discussing this last fall with Jay Rosen at Bloggercon. The software business uses the term legacy to describe mothballed code, or something that is no longer updated. Generally, this term is used when a customer is moving from software product/platform a to product/platform b (DOS to Windows, Unix to Linux, terminals to client/server to web services).

There will always be journalism, some great, some not so great. It will simply be delivered many different ways.