Retail Futures: UK Sector Summary Q4 2007

TABLE OF CONTENTS
CHAPTER ONE: EXECUTIVE SUMMARY

Out of Pocket Expenditures : Current Market
The U.S. Healthcare Market
The Need for Alternatives
High Cost of Care
Inconsistent Quality of Care
Inaccessible Care
Vulnerable Populations
Consumers Who Pay Out of Pocket
Medicaid Recipients
Disabled Persons
Senior Citizens
The Mentally Ill
Obese Persons
Persons with Chronic Medical Conditions
Health Care Reform
Types Of Out Of Pocket Payments
Insurance Co-Payments
Direct Payments
Premiums and Plan Fees
Payment Methods
Cash or Check
Credit Cards
Flexible Spending Accounts
Loans and Lines of Credit
Health Savings Accounts
Health Care Financing
Non-Elective Procedures and Prescription Drugs
Types of Expenses Financed
Elective Procedures
Non-Elective Procedures and Prescription Drugs
Trends In Out Of Pocket Spending
Health Care Inflation
Managed Care Cost Shifting
Retail Clinics
Disease Management Programs
Medicare Prescription Drug Benefit
Generic Drugs
Rx-to-OTC Switches
Medical Tourism
Health Care Advisers
Medical Procedure Financing
Types of Procedures Financed
Elective Procedures
Non-Elective Procedures
Financing Products
Scope and Methodology

CHAPTER TWO: HEALTH CARE PAYMENTS AND COVERAGE

Overview
Public Health Care
Private Health Care
State-Licensed Health Insuring Organizations
Commercial Health Insurers
Blue Cross and Blue Shield Plans
Health Maintenance Organizations
Self-Funded Employee Health Benefit Plans
Participation
Cost Issues
The Uninsured And Underinsured
The Uninsured
The Underinsured
Regulation
Health Care Reform
Universal Federal Health Care Coverage
State Health Care Coverage
Current State Health Care Initiatives
Federal Support of State Health Care Reform

CHAPTER THREE: OUT-OF-POCKET EXPENDITURES: THE CURRENT MARKET
Overall Out-Of-Pocket Spending
Payments Types
Insurance Co-Payments
Direct Payments
Premiums and Plan Fees
Payment Methods
Cash or Check
Credit Cards
Flexible Spending Accounts
Loans and Lines of Credit
Health Savings Accounts
Health Care Financing
Amount Financed
Elective Procedures
Non-Elective Procedures and Prescription Drugs
Consumers Who Pay Out Of Pocket
Medicaid Recipients
The Disabled
Senior Citizens
The Mentally Ill
Obese Persons
Persons with Chronic Conditions
CHAPTER FOUR: OUT-OF-POCKET EXPENDITURES: THE MARKET IN 2007-2011

Trends
Out-of-Pocket Expenditure Growth Drivers
Health Care Inflation
Managed Care Cost-Shifting
Retail Clinics
Services
Pricing
Consumer Response
Expansion
Out-of-Pocket Expenditure Growth Constraints
Disease Management Programs
Medicare Prescription Drug Benefit
Generic Drugs
Private-Label OTC Medications
Rx-to-OTC Switches
Medical Tourism
Health Care Advisers
Forecasts
Payment Type
Payment Methods
Amount Financed
Elective Procedures
Non-Elective Procedures
Consumers Who Pay Out of Pocket
CHAPTER FIVE: SOURCES OF MEDICAL PROCEDURE FINANCING, 2006
Types Of Procedures Financed
Elective Procedures
Chiropractic Services
Cosmetic Surgery
Cosmetic Dentistry
Elective Eye Procedures
PRK Procedures
LASIK Procedures
LASEK
Forecast
Hair Restoration
Fertility Treatments
Weight Loss Surgery
Non-Elective Procedures
Financing Programs
Costs to Consumers
Costs to Providers
Usage and Acceptance
Key Players
Elective Procedures
Non-Elective Procedures
CHAPTER SIX: SOURCES OF MEDICAL PROCEDURE FINANCING, 2007-2011
Trends
Consumers
Consumer Debt
Payday Loans
Weak Housing Market
Widening Wage Gap
Financial Awareness
Security Concerns
Financial Institutions
Increasing Share of Wallet
New Credit Card Products
New Credit Card Customer Segments
Forecasts
CHAPTER SEVEN: COMPANY PROFILES
APFUSA
Aurora Quick Care
Capital One Healthcare Finance
Care Credit
Checkups
Credit Medical
CSI Financial Services
Health Ready
Medchoice Financial
Meddirect
Medprova
Minuteclinic
PFS
Rediclinic
Reliance Medical Finance
Solantic
Springstone Patient Financing
Take Care Health Systems
Target Clinical Medical Associates
TABLE OF EXHIBITS

CHAPTER ONE: EXECUTIVE SUMMARY
Figure 1-1:The U.S. Out of Pocket Healthcare Market, 2006-2011, Elective and Non-Elective Spending (in billions)
Figure 1-2: U.S. Consumer Out-of-Pocket Health Care Expenditures by Service Required, 2006
Figure 1-3: U.S. Healthcare Consumers Highly Likely to Pay Out of Pocket, 2006-2011 (millions)
Figure 1-4: U.S. Healthcare Consumers Likely to Pay Out of Pocket, by Contributing Factor 2006 (Persons with Chronic Conditions, Medicaid, Disabled, Senior Citizens, Mentally Ill, Obese)
Figure 1-5 : Average Share Paid Out of Pocket by U.S. Consumers, by Percentile of Total Health Care Spending and Type of Service, 2003

CHAPTER TWO: HEALTH CARE PAYMENTS AND COVERAGE

Figure 2-1: National Health Expenditures (NHE) and NHE as a Percentage of GDP, 1980-2011
Figure 2-2: Premium Increases vs. Increases in Workers� Earnings and Inflation, 1989-2005
Table 2-1:Selected U.S. Federal and State Health Care Oversight Bodies,2007
Table 2-2:U.S. Health Care Coverage by State,2007
CHAPTER THREE: OUT-OF-POCKET EXPENDITURES: THE CURRENT MARKET
Figure 3-4: Average Share Paid Out-of-Pocket by U.S. Consumers, by Percentile of Total Health Care Expenses, 2003
Figure 3-5: Average Amount Paid Out-of-Pocket by U.S. Consumers, by Percentile of Total Health Care Expenses, 2003
Figure 3-1: U.S. Consumer Out-of-Pocket Health Care Expenditures: Direct Payments, Co-Pays and Premiums, 2006
Figure 3-2: U.S. Consumer Out-of-Pocket Health Care Expenditures by Payment Type, 2006
Table 3-1: Credit Card Debt of Consumers with Medical Debt by Health Insurance Status,2007
Table 3-2: Credit Card Debt of Consumers with Medical Debt by Demographic Group, 2007
Figure 3-3: Methods of Payment for Elective Procedures, 2006
Figure 3-4: U.S. Consumer Out-of-Pocket Spending for Elective Procedures, Amount Financed vs. Paid with Cash or Check, 2003
Figure 3-7:Average Share of U.S. Health Care Expenses Paid Out of Pocket, by Type of Service, 2003
Figure 3-8: Average Share Paid Out of Pocket by U.S. Consumers, by Percentile of Total Health Care Spending and Type of Service, 2003
Figure 3-9: Distribution of Out-of-Pocket Spending on Non-Elective Procedures for the Average Person, 2003 71
Figure 3-10: Distribution of Out-of-Pocket Spending for the Average Person, by Spending Level and Type of Service, 2003
Figure 3-11: Drug Cost Coverage by Payor Type (Public, Private, Cash), 1965, 1986, 2000, 2004
Figure 3-12: Change in Out-of-Pocket Health Care Expenses for Medicaid Recipients, 1997 to 2002
Figure 3-13: Out-of-Pocket Health Care Expenses for Disabled and Non-Disabled Medicaid Recipients, 1997 vs. 2002
Table 3-3: Obesity in the U.S., 1980-2011
Figure 3-14: Adults Under Age 65 with Chronic Conditions by Type of Insurance, 2003
CHAPTER FOUR: OUT-OF-POCKET EXPENDITURES: FORECASTED MARKET TO 2011
Figure 4-1: Extent to Which Consumers Believe Cost-Shifting Will Result in Beneficial Outcomes, 2003
Figure 4-2: Growth of U.S. Retail Clinics, 2001-2011
Table 4-1: Selected Rx-to-OTC Switches in the United States, 1982-2007
Table 4-2: Rx-to-OTC Switch Candidates in the U.S., 2007-2012
Table 4-3: Cost Savings From Medical Tourism for Various Procedures, 2007
Table 4-4:U.S. Consumer Out-of-Pocket Expenditures per Worker, 2001-2011
Table 4-5: U.S. Consumer Out-of-Pocket Expenditures by Payment Type, 2001-2011
Figure 4-3: Distribution of U.S. Consumer Out-of-Pocket Spending by Payment Type, 2001, 2006, 2011
Table 4-6:U.S. Consumer Out-of-Pocket Expenditures by Payment Method, 2001-2011 Figure 4-4: Distribution of U.S. Consumer Out-of-Pocket Spending by Payment Method, 2001, 2006, 2011
Table 4-7: Amount of U.S. Consumer Out-of-Pocket Expenditures for Elective Procedures , 2001-2011 (in billion $)
Figure 4-5: Share of U.S. Consumer Out-of-Pocket Spending for Elective Procedures Paid for Through Financing, 2006-2011
Table 4-8: Amount of U.S. Consumer Out-of-Pocket Expenditures for Non-Elective Procedures , 2001-2011 (in billion $)
Figure 4-6: Distribution of Out-of-Pocket Spending on Non-Elective Procedures for the Average Person, 2006 vs. 2011
Figure 4-7: Share of U.S. Consumer Out-of-Pocket Spending for Non-Elective Procedures Paid for Through Financing, 2006-2011
Table 4-9: Size of High-Risk Groups for High Out-of-Pocket Health Care Expenditures, 2001-2011 (in millions)
CHAPTER FIVE: SOURCES OF MEDICAL PROCEDURE FINANCING, 2006
Figure 5-1:Distribution of Medical Procedure Financing Market, 2006
Table 5-1:Cosmetic Surgical Procedures Offered in the U.S., 2007
Table 5-2: Firtility Treatments in the U.S., 2007
Table 5-3:Leading Weight Reduction Surgeries Offered in the U.S., 2007
Table 5-4:Comparison of Selected Medical Financing Program Costs to Consumers, 2006
Table 5-5:Selected Elective Procedures Covered by Leading Medical Financing Companies, 2007
Figure 5-2:Leading Players� Share of U.S. Elective Procedure Financing Market, 2006
Table 5-6:Selected Non-Elective Procedures Covered by Leading Medical Financing Companies, 2007
Figure 5-3:Leading Players� Share of U.S. Elective Procedure Financing Market, 2006
CHAPTER SIX: SOURCES OF MEDICAL PROCEDURE FINANCING, 2007-2011
Table 6-1: Consumer Out-of-Pocket Expenditures for Elective Procedures Paid Through Patient Financing Programs, 2001-2011 (in billion $)
Table 6-2: Consumer Out-of-Pocket Expenditures for Non-Elective Procedures Paid Through Patient Financing Programs, 2001-2011 (in billion $)
Figure 6-1: Consumer Out-of-Pocket Expenditures for Elective and Non-Elective Procedures Paid Through Patient Financing Programs, 2001-2011 (in billion $)
Figure 6-2: Proportion of Consumer Out-of-Pocket Spending for Elective Procedures Paid Through Patient Financing Programs, 2006-2011