Regulation from an
Any discussion of health plan regulation can be informed by a brief review of how the health care marketplace has changed—and continues to change—in response to the demands of consumers. In fact, over the past ten to fifteen years, health insurance and health plans have evolved in response to what consumers wanted, and the result has been no less than a revolution in how health care is financed and delivered.
Employers who purchase health plans, and the employees and dependents enrolled in the plans, are the two primary groups of consumers to dominate today's health care marketplace. It is the combined interests of these consumers that have transformed the health care system. As a recent KPMG Peat Marwick study shows, a majority of health plan executives believe that consumers influence the policy, strategy, operations, even the investment decisions of their organizations. And 90 percent said that their plans expanded the number and type of services they offer based on consumer preferences. 1 The conclusions of this survey are also reflected in the recent history of change in the health care marketplace.
More than a decade ago, businesses said: “Health insurance is too expensive.” And it was. Purchasing health benefits was moving