Deductibles are a form of cost-sharing and the cost share that your required to participate in has crept up since the late 1990’s. It was typical to spend more than $1000 out of pocket. Now you find that your deductible can be up to 10 times that before your coverage will start.
Deductibles and co-payments are used to force patients to behave more like consumers in different parts of the economy. It won’t be the full price of an MRI (Magnetic Resonance Imagery machine), but if you have options, you may select one that you can find cheaper. Patients may forego the surgery until the pain becomes even more unbearable.
This is an effort to modify behavior since part of the burden rests on the patient. They are more likely to chose less costly options and over time the market provides less costly options to service customers through competition. If customers cannot afford time to shop, they can still choose the more expensive options.
However, the theory only works on paper. In a study on workers with high deductible plans did not shop for expensive medical services. They, instead cut less expensive services and wellness in order to offset costs. Sometimes there is no option for less expensive MRI or it is very far away, or timeliness of testing is not an option.
The majority simply do not have enough savings to work with a high deductible plan. In a study with the Kaiser Family Foundation, when faced with medical costs a substantial segment of a group struggling with healthcare bills were left to struggle to cut thousands form their budgets to cover health care.
*1 “For those people, deductibles often seem like an unfair trick, or a feature that makes insurance worthless. More than 3,000 readers wrote us about that medical debt article, many deploring high deductible health plans that had put them in financial distress.
Dr. Peter B. Bach, an oncologist and the director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, said he had seen patients discontinue lifesaving treatments when the year ran out, because they could not afford another big deductible. He argued that the problem with deductibles was that few people really can control whether or when they will be struck by an illness that requires expensive treatment. “There’s essentially nothing they can do to prevent the likelihood they’ll have high-cost health events,” he said.”
content from The New York Times article “The Big Problem With High Health Care Deductibles” Feb 1,2016.