Health-care roles in America have been changing. Individuals pay approximately $1 trillion a year on health care and coverage costs out of pocket. Nearly 44 percent of privately insured adults have deductibles of $1,300 or more, yet many do not realize it until a bill arrives, sometimes months after the always confusing “This is Not a Bill." Not everyone can absorb the surprise; more than half of Americans have less than $1,000 in savings.

 

Then why don't Americans shop for health care the way we do everything else? Despite bearing financial burdens for more of our health-care expenses, many people do not feel or function as true health-care customers, with a sense of entitlement to get a health-care system that works for them.

 

But in mental health care, patients are already consumers and customers, often out of necessity. Only 55 percent of psychiatrists accept insurance, so many consumers who need care must pay out of pocket. This financial burden can make needed mental health care inaccessible for many. Yet operating outside the insurance system means that those who can afford it may get better, more personalized care.