(Editor’s Note: As a candidate for Mayor of Port Orchard, I believe it is inappropriate for me to continue writing this column — at least until after the election. During the period between now and then, we will feature guest columnists commenting on whatever issues they want to share with our readers. This issue, Elizabeth Gilje, the recently retired CEO of KPS Health Plans, shares her thoughts on the future of health care. — LFC)

In the past, decisions regarding benefit richness, deductible options and physician networks were exclusively decisions of employer human resource departments or company owners. More often, their concerns were rising medical insurance premiums, deductibles, and lost employee time. Employees could seek services from the most expensive physicians and facilities without regard to cost. The cost of service was hidden from the patient. In the future, State and Federal legislation will give individual consumers more responsibility for health care decisions. Individual consumers could be the savvier of the health industry. Individual consumers have new demands: they want to save money by controlling costs, flexible retail options and they demand service.

Surely, you have heard the terms health savings account and well care or prevention program. These are up front methods of giving the reins back to the individual, giving the consumer control of their body and health care costs. The consumer will have the responsibility when spending health care dollars along with the choice of taking better care of their body to possibly avoid a major health care intervention in their future. Giving choice to the consumer may be the only way to break current medical inflation trends which have been rising three times faster than general inflation.

Consumer driven health care is most associated with Health Savings Accounts (HSA) and other high deductible health insurance products. With a HSA, the consumer is in control of spending their savings account money. The consumer can choose to save it for retirement or spend it on approved medical items. With high deductibles, the consumer may become a thriftier patient as they shop for medical services by studying market pricing and looking for the best price and quality. Consumers of HSAs are more likely to use preventative care and less likely to be frivolous with their health care budget.

Today, the Federal government covers over two million Federal employees and the U.S. administration has now mandated transparency, online wellness programs and HSAs for their employees. The way is paved for the industry to follow.

Price transparency requires medical providers to disclose their prices upfront so patients can shop for services. Medical procedure cost information is already widely available on the Internet.

Larger hospital systems, such as Harrison Medical Center, are streamlining channels and educating the public on proper facility use. One example is the creation of regional urgent care centers for lesser medical situations than what should be seen at an emergency room. This reduces consumer and industry expense and clears the emergency waiting room for when a life threatening crisis occurs.

“I think our greatest focus will be on expanded access points with clinics, urgent care centers and hospitals,” says Scott Bosch, Harrison Medical Center Administrator. “We will continue to recruit adequate staff to better our efficiency and build capacity to meet the needs of the growing population, especially the aging population, and their geriatric needs.” Harrison Medical Center has planned an expansion of services for patients in North Mason. Longer range plans include collaborative work with local providers in Jefferson and Clallam counties.

Another emerging consumer cost saver, is the creation of mini clinics within pharmacies and store chains such as Walmart, Walgreens, and CVS. Typically staffed by nurse practitioners and physician assistants, they require no appointment, and only treat minor conditions such as bladder infections, strep throat, and poison ivy. They give pregnancy tests, vaccines, remove stitches and write prescriptions. Charges for the clinics are about $60 per visit. No health insurance is required to use a mini clinic.

Even closer to home is wellness education through Internet health information portals such as Subimo, WebMD or through your own health plan such as MyKPS.net. Internet services allow consumers to learn about conditions, compare symptoms, educate themselves to improve health, or manage a chronic care condition.

The Internet is an emerging tool that is creating one of the greatest changes in the health care industry. “Putting web-based information into the hands of the consumer as it relates to consumer driven health care, transparency and wellness, is here,” explains Pam Tirao, KPS Vice President, Business Systems. “The new movement is in the direction of electronic health records to be used by consumers, providers, and health plans in the more distant future.”

Electronic health records and personal health records can be kept online to provide improved safety and medical consistency by allowing physicians easy access to the patient’s medical information, especially during an emergency. The online record is useful in identifying duplication of medications and testing. Larger multi-specialty clinics and HMOs have embraced online health record systems already. Other ways of consolidating health information is with a card, similar to a credit card handed to the medical provider receptionist at the time of service.

What is the future of health care? I’ve given you a glimpse of what we know to be certain. However, more than ever, it is not the choice of the government, employers or insurance carriers to fully determine. It is up to you, the consumer.