It took a proofreader to remind me the other day about how confusing so much of health care jargon is out there. On a comparison chart, the edits noted “Wouldn’t it make sense that the preferred drugs are the most expensive?” The widely-adopted “preferred brand name” and “nonpreferred brand name” labels are very common in prescription drug benefits. But, preferred by whom? “Preferred” drugs are preferred by the plan because they are less expensive or have better outcomes than other brand name drugs that may be highly-advertised (and may be “preferred” by the patient) but more expensive for the plan. It is no wonder employees are confused by these labels—they are created from the perspective of the plan, not the patient.
Likewise, I’ve seen just as confusing of labels for health plans. For one company, the “Preferred Access” plan is actually the plan where you can see any doctor and the “Open Access” plan is an HMO where you have to stay in network—doesn’t sound very open to me!
I’d like more time and thought put into naming health plan benefits so that they actually make sense to the users of the benefits. So much time is spent explaining how plans work (in large part because little of it is intuitive) while we could be investing that time in teaching people how to be healthier overall.