Julie Appleby of Kaiser Health News has an intriguing story about five insurers in Oregon offering "value-based insurance design."
She explains:
"...a new type of insurance that offers free care for some illnesses, such as diabetes or depression, but requires hefty extra fees for treatments deemed overused, including knee replacements, hysterectomies and heart bypass surgery.
...The policies are among the first to apply financial incentives on both sides of one important factor driving up the nation's health care tab: The underuse of proven treatments and overuse of certain surgeries and diagnostic tests that may be less valuable."
Not as enlightened as it would appear, given that they will offer for free the "proven" effectiveness of antidepressants when data show they act as placebos for all but the very severely depressed. That seems to have become an empiricism-proof protocol at this point. And we should not forget the fact that a fifth of all people taking SSRI's are now prescribed an adjunct course of atypical antipsychotics, some of which cost $400 a month.