Dollars and sense: the economics of personal health decision-making

The economic consequences of personal health care decision-making have received relatively little attention in the United States. The majority of the American public is shielded from an awareness of the cost impact of health services by first dollar health insurance coverage and modest out-of-pocket personal payments. As the various current structural changes in the reimbursement system for health care begin to manifest themselves in terms of mandating individual responsibility for paying a significant portion of health care, Americans will require and demand a deeper understanding of how much their health is costing them. In addition, as individuals realize that up to 50% of disability and death can be attributed to negative lifestyle health behaviors, the interrelationship of personal economic status and health status will create a new consciousness of the value of preventive health practices and health education. This article provides an in-depth analysis of the social forces in America compelling individual health decision-making in economic terms, barriers to informed health decision-making, a suggested matrix for making quality-vested health decisions (with case examples) and a discussion of available resources for assisting in the decision-making process.