UnitedHealth learned the meaning of deferred care with first year patients in its Medicare practice.

Hewitt Associates benefits design expert Jeffery D. Munn summarized: “Employers have seen some good initial cost savings from consumer-driven plans, (but) there is a longer-term concern about whether the savings are coming from wiser consumers, or they are just not going to the doctor because they would have to spend more out of pocket.”

An Obama advisor, not unauthorized to speak for the new President, said that shifting healthcare costs to employees is not consistent with their vision. When the employees’ pain is large enough to matter, employees start having to choose between necessities and preventive care, and eventually defer care that is really important. That’s when employers and insurers see real cost savings. The greater the cost savings for employers and insurers, the more employees will call President Obama for help.

Consider the added costs of high deductible plans: health savings account administration, more complicated claims processing for employers and insurers, and more collection costs for doctors and hospitals. And we are not getting the type of behavioral changes for this additional spending that the idealists have predicted. Consumers are either ignoring the deductible in decision making and spending through it, or foregoing care.

All is not bad for employers and private health insurers. We are in the dark phase now with high costs for employers and diminishing membership in the private health insurers. But, an all inclusive healthcare system will reduce everyone’s costs and provide unlimited membership upside potential for private health insurers. Everyone wins and they know it. This time around “Harry and Louise” are supporting change.

Disclosure: Author is long UNH.