Tuesday, January 10, 2017

Cost of high deductibles

I try to stay away from politics on this site--I find the incoming president utterly distasteful and undeserving of respect, but I express this elsewhere.

But I cannot completely stay away from Obamacare  If people have no insurance (my daughter has fit this from time to time), it means many times they seek no care or live with dangerous ailments way too long.

With the high deductibles insurance companies (supposedly) had to impose in many Obamacare plans to offset the required coverage, insurance holders in those plans have insurance, yes, but now in January are starting the clock over--paying out of pocket for the first $1300 or $5000 worth of expenses. If they need an operation, some surgeons will ask for this amount in advance.

Some researchers at the VA Ann Arbor Health Care System, University of Michigan Medical School, and Penn State (JAMA Internal Medicine), found that high-deductible plans now cover 40% of those who buy their own plan or get it through their employer.

For Americans under 65, this means that health related costs take up more than 10% of the income of the chronically ill. Even low-deductible plans, in some cases, involved a lot of out of pocket for chronic conditions.

Still, these patients said the high deductibles had not interfered with getting their prescriptions.

The findings were based on 2011-13, when the high-deductible plans started being offered by employers and before Obamacare.

In 2013, high-deductible meant patients paid $1,250 in are costs for a person and $2,500 for a family. Only people with deductibles above this can open Health Savings Accounts, tax-advantaged accounts allowing them to use their own money for expenses.

(These have been touted as a big solution to the cost of care--in the Republican replacement scenarios--but I have my doubts.)

One justification for high deductible plans is to make consumers more involved in their care and more aware of cost. The researcher said, though, that they were sure how often people used the so-called cost transparency tools showing which doctors and hospitals offered the most value. (What are these tools? I don't know.)

In my opinion, this would be because patients have to pick doctor' in a designated network, whether or not they are the best value.

The researchers also noted that doctors and their offices are disconnected from the patient's financial concerns. Patients could get help navigating whether they can afford or should get a certain test or operation if doctors operated this way.

An important step would be to help patients avoid care they don't need--how about it, doctors?

2 comments:

Anna Maria said...

I agree on how distasteful the newly elected POTUS is. What were they thinking? As for health insurance and all it's expense and controversy it is causing, I can't help but think back to the 50's and 60's when almost everyone was well covered by Blue Cross/Blue Shield and the cost was very low so that almost all employers offered it as a benefit. Back then they were a non profit insurance company and it's when they changed to for profit and other huge insurance companies emerged is when premiums started going up and have kept rising for prescription drugs as well. Everyone wants to make a profit but the greed that has ensued is ridiculous. When you look at what the salaries are of the CEO's and upper echelon of the healthcare industry it's a small wonder that anyone can afford health insurance anymore. With the new administration I feel the problem is only going to be exacerbated...not resolved. Oh woe be America!

Star Lawrence said...

I remember those days, too. And for 35 yrs I bought health insurance for my daughter and myself on the open market--it never went over $800 a mo and we just took out the card at the doctor or hosp and lived to tell the tale. When she turned 18, I bought her a separate policy--cheaper than keeping her on mine. Last month, even on a Medicare HMO, I had to pay part of lab costs...everything goes up and up...and the drugs--those are so arbitrary..One yr, your med is Tier One, free of a copay or $2...then the next, $40.