High deductibe health plans: savings vs. health-cost risk! beware

More employers are offering high-deductible health plans and more workers are willing to choose lower-priced plans that require them to pay more out of pockets for health care.  This strategy is embraced by public and private exchanges to keep the rising costs of healthcare down (will it?).  Supporters of high-deductible plans claim that people will become smarter health care consumers more aware of health care costs and willing to discuss choices and options with providers.  It may be a good deal for people who are generally healthy, rarely see doctors and could afford ($1000-7000 range deductibles) thousand dollars for medical care when needed.  So what are the down sides?

A study by Galbraith in JGIM showed that the odds of reporting delayed or forgone care due to cost were 3-4 times greater for adults and children with high deductible health plan compared to traditional plan families.  Lower-income families in HDHPs have increased rates of cost-related delayed and forgone care.  According to a recent article by Reed in Health Affairs, 19% of plan members surveyed reported delaying or avoiding a preventive office visit, test, or screening because of cost even though it was exempted from their deductible.  Most health plan members surveyed have low awareness of preventive cost-sharing exemptions. 

Health insurance is supposed to protect members from financial worries, debts, promote healthy lifestyle and prevention practice.  A study published in AJM suggested that about 62% of all bankrupcies in 2007 were medical before the major impact of the housing collapse and recent economic downturn.  We are indeed full of contradictions when it comes to health care policies and practices.  We believe in safety net and we have supported many on Social Security disability programs, but we don't believe in health insurance that is straightforward and well-designed--protect all of us from medical expenses we could not easily afford on our own.  Perhaps our health system is getting too complex (understatement), too many band-aids and too many self-interest groups wanting status quo.  There is an alternative proposal.  To find out more...