Nonetheless, I encourage people to contact the Department of Health and Human Services and express their point of view on what information they need from the insurance industry. You can be sure H.H.S. is hearing plenty from the insurance industry. It also needs to hear from consumers.

Q. What about the trend toward so-called consumer-driven health care? This has led to a major increase in the use of high-deductible health care plans by employers and individuals. But can people realistically afford these policies?

A. The industry push toward consumer-driven health care is one of the reasons I left my job. I didn’t like having to be a spokesperson for these plans, because it was clear that many people with modest incomes could not afford them.

Take a couple I write about in my book. She’s a schoolteacher, and he is self-employed. They have five children. With a deductible of $11,000, the couple was paying almost all of their health care bills out of pocket. It didn’t take long for them to realize that with that kind of burden, they could no longer afford the $858 monthly premium. Something had to give.

“Consumer-driven” was certainly not invented by consumers, as the name implies. It was invented by executives of insurance companies and big corporations, who saw this as a way to shift more of the cost from their firms to consumers.

There is the notion that once people have more skin in the game, they’ll become more sophisticated and savvier users of health care. The reality is that more and more people are forgoing needed care in these plans. People who don’t get the care they need are more likely to have an emergency, driving up health care costs.

Worse, the industry was so successful in persuading lawmakers that consumer-driven was an irreversible trend, the new health care law doesn’t do enough to address high-deductible policies. That’s one of my great disappointments with the new law.