The consumer-directed health care world is buzzing these days about the concept of consumer engagement. Much has been written and said about the best ways to educate people about the health care system, how it works, and how they can be taught to make better decisions that will reduce spending. It's an awesome task.

Or is it?

While carriers can manufacture plan designs that give the member more responsibility for paying for routine care, they are unlikely candidates to actually change the health care purchasing habits of their members. For the most part, health plans have been strictly wholesale. Their customers are the brokers who sell the plans and the employers who buy them – not the end user.

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