There have been a few interesting articles on high-deductible health insurance plans on the blog this week. The idea of cost-sharing seems to make good sense on paper, but I wonder if these plans will have unintended consequences in practice, particularly for those with middle to low incomes. As this study points out, those with low incomes are more likely to delay needed care as a result of cost concerns. Value-based insurance, which reduces or eliminates a patient’s out of pocket costs for treatments that are proven to be effective, may hold potential for alleviating the potential problems associated with HD plans. However, this type of insurance carries the added risk of becoming overly complex and difficult for patients to understand, once again resulting in underutilization of services.
Aside from these potential pitfalls, I believe there is another issue that is not receiving as much attention. For many middle and lower class individuals, a switch to a high deductable health insurance plan would constitute a significant erosion in the benefits they receive from their employers. Generous health benefits are becoming a thing of the past, and while greater cost shifting falls on patients, I think its very unlikely that we’ll also see concurrent rise in their wages. With this in mind, I think policy makers should carefully consider whether HD health plans will actually result in long term cost savings. Or, will they simply make health care less accessible for the majority of Americans while making them poorer? If the latter is the case, I find it hard to believe that our population’s health will do anything but worsen.
Interestingly, this article focused on a population that has been overlooked by researches for a long time. The low-income people who are not eligible for Medicaid but have not enough money to obtain full-scale health care. They do not receive Medicaid benefits. However, out-of-pocket medical expenses take a big proportion of their income and practically make them live below the poverty level. It was found that lower class people have to make health care decisions based on affordability, not medical effectiveness. Therefore, lower class people with income above poverty level become the most vulnerable people in our health care system. More researches could be conducted to aim at this population. For example, what is impact on lower-income population with chronic diseases? Will they receive inexpensive but less effective medications and have shorter healthy days? Will they have poorer function status than others? findings can be presented to the Congress for policy changes.
There have been a few interesting articles on high-deductible health insurance plans on the blog this week. The idea of cost-sharing seems to make good sense on paper, but I wonder if these plans will have unintended consequences in practice, particularly for those with middle to low incomes. As this study points out, those with low incomes are more likely to delay needed care as a result of cost concerns. Value-based insurance, which reduces or eliminates a patient’s out of pocket costs for treatments that are proven to be effective, may hold potential for alleviating the potential problems associated with HD plans. However, this type of insurance carries the added risk of becoming overly complex and difficult for patients to understand, once again resulting in underutilization of services.
ReplyDeleteAside from these potential pitfalls, I believe there is another issue that is not receiving as much attention. For many middle and lower class individuals, a switch to a high deductable health insurance plan would constitute a significant erosion in the benefits they receive from their employers. Generous health benefits are becoming a thing of the past, and while greater cost shifting falls on patients, I think its very unlikely that we’ll also see concurrent rise in their wages. With this in mind, I think policy makers should carefully consider whether HD health plans will actually result in long term cost savings. Or, will they simply make health care less accessible for the majority of Americans while making them poorer? If the latter is the case, I find it hard to believe that our population’s health will do anything but worsen.
Interestingly, this article focused on a population that has been overlooked by researches for a long time. The low-income people who are not eligible for Medicaid but have not enough money to obtain full-scale health care. They do not receive Medicaid benefits. However, out-of-pocket medical expenses take a big proportion of their income and practically make them live below the poverty level. It was found that lower class people have to make health care decisions based on affordability, not medical effectiveness. Therefore, lower class people with income above poverty level become the most vulnerable people in our health care system.
ReplyDeleteMore researches could be conducted to aim at this population. For example, what is impact on lower-income population with chronic diseases? Will they receive inexpensive but less effective medications and have shorter healthy days? Will they have poorer function status than others? findings can be presented to the Congress for policy changes.