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While pro-market conservatives like to say that high deductibles keep costs down because people will "think harder" about asking for expensive, potentially-unnecessary tests, the main effect is to keep people who need treatment but can't afford the up-front out-of-pocket payments from going to the doctor to get that little thing taken care of before it becomes a huge thing, or for routine preventive care.
Via the Mad Biologist comes a story from the New York Times about people foregoing necessary care because they can't afford to meet their deductibles.
For someone like Shannon Hardin of California, whose hours at a grocery store have been erratic, there is simply no spare cash to see the doctor when she isn't feeling well or to get the $350 dental crowns she has been putting off since last year. Even with insurance, she said, "I can't afford to use it." Delaying care could keep utilization rates for insurers low through the rest of the year, according to Charles Boorady, an analyst for Credit Suisse. "The big question is whether it is going to stay weak or bounce back," he said. "Nobody knows."
High deductibles also can be daunting. David Welch, a nurse in California whose policy has a $4,000 deductible, said he was surprised to realize he had delayed going to the dermatologist, even though he had a history of skin cancer. (emphasis mine)
Mike: I understand the need to cut down on unnecessary spending--and many plans' 'unnecessary' ER deductibles are low, especially in the People's Republic of Massachusetts--low for me, anyway*. But for some people, they can't even afford a $100-$200 deductible. That is what poverty means. This 'efficiency' is going to get people killed. (emphasis mine)
So all you folks blithely saying that high deductible plans are great and that health insurance ought to be only for unforeseen catastrophes, not routine care or prescriptions (or even things like physical therapy and psychotherapy, because those aren't, like, CANCER or a broken leg), what you're actually saying is that the poor deserve to die from completely treatable medical conditions.
If you want more transparency of costs, I'm with you, but when someone has food poisoning or a heart attack or is involved in a car accident, they're not going to be shopping around for which hospital has the best rates. They're going to go wherever's closest, or wherever the ambulance takes them.
(This is why medical care cannot be likened to buying a washing machine. Aside from the disparity of information (doctors vs patients), someone in an emergency situation is NOT going to do a little comparison shopping before getting in the car/ambulance. For elective care, like knee replacements, sure, but price isn't the only factor.)
Via the Mad Biologist comes a story from the New York Times about people foregoing necessary care because they can't afford to meet their deductibles.
For someone like Shannon Hardin of California, whose hours at a grocery store have been erratic, there is simply no spare cash to see the doctor when she isn't feeling well or to get the $350 dental crowns she has been putting off since last year. Even with insurance, she said, "I can't afford to use it." Delaying care could keep utilization rates for insurers low through the rest of the year, according to Charles Boorady, an analyst for Credit Suisse. "The big question is whether it is going to stay weak or bounce back," he said. "Nobody knows."
High deductibles also can be daunting. David Welch, a nurse in California whose policy has a $4,000 deductible, said he was surprised to realize he had delayed going to the dermatologist, even though he had a history of skin cancer. (emphasis mine)
Mike: I understand the need to cut down on unnecessary spending--and many plans' 'unnecessary' ER deductibles are low, especially in the People's Republic of Massachusetts--low for me, anyway*. But for some people, they can't even afford a $100-$200 deductible. That is what poverty means. This 'efficiency' is going to get people killed. (emphasis mine)
So all you folks blithely saying that high deductible plans are great and that health insurance ought to be only for unforeseen catastrophes, not routine care or prescriptions (or even things like physical therapy and psychotherapy, because those aren't, like, CANCER or a broken leg), what you're actually saying is that the poor deserve to die from completely treatable medical conditions.
If you want more transparency of costs, I'm with you, but when someone has food poisoning or a heart attack or is involved in a car accident, they're not going to be shopping around for which hospital has the best rates. They're going to go wherever's closest, or wherever the ambulance takes them.
(This is why medical care cannot be likened to buying a washing machine. Aside from the disparity of information (doctors vs patients), someone in an emergency situation is NOT going to do a little comparison shopping before getting in the car/ambulance. For elective care, like knee replacements, sure, but price isn't the only factor.)
