​The painful rise of high-deductible health insurance

[groundloop]

Source: CBS News

As Americans this year signed up for new health care policies through their employers or the Affordable Care Act, many received an unwelcome tweak: even higher deductibles than in prior years.

Deductibles, or the amount individuals must pay out of pocket before their insurance kicks in, have surged 67 percent since 2010 alone for employer-sponsored health-care plans, according to the Henry J. Kaiser Family Foundation. The average individual deductible for a bronze plan through the ACA, meanwhile, tops $5,700 for 2016, according to research from plan-comparison site HealthPocket.

"When consumers have more cost sharing, do they spend less? We're finding yes," said Benjamin Handel, assistant professor of economics at the University of California, Berkeley. "Then you have to ask how is spending going down: Is it because consumers are acting in a sophisticated manner and shopping for providers and prices and reducing quantities of wasteful care, or are they viewing this as a fairly blunt instrument?"

The latter, it turns out. Consumers tend to respond to higher deductibles by cutting back across the board, regardless of whether the treatments are useful or potentially wasteful, according to a paper from Handel and fellow researchers Jonathan Kolstad and Zarek Brot-Goldberg at Berkeley and Amitabh Chandra at Harvard University, published by the National Bureau of Economic Research.



Read more: http://www.cbsnews.com/news/the-painful-rise-of-high-deductible-health-insurance/

---

There's much more information in this article than what can be conveyed in just 4 paragraphs. One conclusion is that people are reducing their quality of care because of rising costs, with the inevitable result being worse outcomes.

[leftyladyfrommo]

1. When I had high deductible insurance

I just didn't go to the doctor unless it was life or death. It cost me $150 for a clinic visit to get my blood pressure meds.

Now that I have Medicare and a $10 co-pay I go more often.

[Kip Humphrey]

2. We need healthcare, not health insurance - vote for Bernie Sanders

Reason #3 why I am voting for Bernie Sanders.

[branford]

4. I like Bernie,

but how exactly will he suddenly expand healthcare without Democratic control of the House and a filibuster-proof majority in the Senate, a VERY unlikely prospect.

This is a problem with all candidates from both parties. I'm less interested in vague aspirational goals than tangible, realistic and feasible plans.

[Kip Humphrey]

7. I can see where this might be a problem for Hillary since she has no path to achievement as

president. Bernie does have a path to achievement. I suggest you study his plan and, if needed, read Paul Wellstone, and any number of treatises on peaceful revolution.

Can Bernie's path to achievement itself be achieved? I think, with difficulty and a lot of work and dedication, yes it can. On the other hand, Hillary has NO plan for achievement, and, in fact, she stirs such animosity and dislike that I expect the one thing a Hillary administration will carry forward from the Obama administration is governmental gridlock.

[branford]

11. I just wanted to note my comment was not meant to be anti or pro either Bernie or Hillary.

My point is that ALL candidates from both parties all to often discuss perfect-scenario goals without any rationale means or plans to achieve their ends.

For instance, it's great to support single-payer healthcare, but we couldn't pass it when Democrats actually controlled the House and had a filibuster-proof majority in the Senate, no less now (and the PPACA arguably lost us the House and a large number of Senate seats). Heck, the very liberal Democratic governor of very blue Vermont, Bernie's home state, had to abandon single-payor because it was impractical and too expensive.

[Kip Humphrey]

13. Like I said, study up on the basis, tactics, and strategies of peaceful revolution to gain

an understanding of how it works and how you can get to universal healthcare, or anything that carries significant public support ( >=60% approval). I realize this may take a little effort on your part, but then, that is the required ingredient for peaceful revolution - effort.

[Z_California]

16. Even if nothing good gets "done" legislation wise

I trust Bernie as the last line of defense against a corrupt Washington. I think of the compromises that won't be made and the wars that will not happen along with the actual enforcement of existing laws that will happen. Plenty of reasons to select the candidate with integrity even if the argument is that everyone will oppose him.

[Elmer S. E. Dump]

27. YEah, like they won't oppose Hillary at all!

[jwirr]

8. And that is exactly why we need to expand the existing plans

into a single payer - because we need tangible, realistic and feasible plans.

For those with high deductibles ACA is not tangible, realistic or feasible.

You are correct though - we need to work on taking the senate back. As for the House WE need to get ready to watch Bernie's back and HELP him win the things that the Rs and New Democrats do not want.

Hillary just says "No we cannot." At lease Bernie is talking about trying. We have more chance with someone who wants to try rather than someone who just keeps saying NO.

[trillion]

12. We will have Democratic control of both houses in the next 8 years.

Democrats are outnumbering Republicans more every years and Roves re-districting falls apart completely within 7. Actually 4 but the Dems will have to re-district back after the 2020 census. We're already re-districting back and the Republicans lost much of Texas because we sued and won re-districting after Obama did a census after 6 years and released the results instead of after 10. After 2023 it's unlikely a Republican will win any major election again in this country if they haven't picked up the minorities. If I didn't have to get to work I'd give you links. Anyway, Bush knows this and thats why he was trying to appeal to the immigrants. Right now we out number the Republicans and just have to show up to vote.

[branford]

17. I recall many proclaiming the death of the Republican Party

Last edited Mon Feb 8, 2016, 01:31 PM - Edit history (1)

after the election of President Obama. Not only were reports of their deaths greatly exaggerated, they now control all of Congress and more state government than in generations.

While I obviously want Democrats to control Congress, I do not take for granted it will happen any time soon, and if we do so, it will likely require many more conservative Democrats in red and purple states, representatives who will probably not support many of the preferred progressive policy options discussed in this thread or elsewhere. This was the situation both under President Clinton as well as President Obama when we controlled Congress and passed the PPACA.

Right now we out number the Republicans and just have to show up to vote.

This has been true for quite some time, and history suggests that relying on Democratic voter turnout is often a losing, and quite frustrating, strategy. I don't personally believe either Bernie or Hillary possesses the charisma or leadership to demonstrably change this very sad predicament, or worse, they're so loathed by Republicans they'll get GOP voters to the polls in droves.

[trillion]

19. I am on my way to work or would start posting actual figures.

There is so much wrong with your post.

They out number us in congress because of the gerrymandering of re-distrcting and voter id laws as well as election fraud.

Actually every thing I read was negative. Rove is now saying he can redistrict forever. WTF.

Deleted.

[trillion]

15. I should also mention that Rove knew they couldn't win without re-districting because they

no longer had the numbers in 2006.

[earthside]

28. Perhaps Pres. Sander would advocate for ...

... and propose legislation creating a public plan option as a transitional phase to nationwide single payer.

A Repuglican Congress would probably be against that too, I suppose, but it would show a direction and a willingness to offer some kind of solution.

I don't believe Mrs. Clinton has offered even a public plan option as part of her plan to allegedly improve Obamacare.

Obamacare is doomed, in my opinion, the further we get into it and as the insurance companies figure out ways to game the system for their own advantage and profit ... like raising the deductible.

The only way in the long run to make health care affordable for all Americans is to eliminate the health insurance industry through a government single payer - private provider plan.

And the only candidate for president even talking about this is Sen. Sanders ... and that is good enough for me to gain my support. We have to have the discussion and debate even if the near and intermediate term prospects for enacting that kind is system is off into the future.

[Maedhros]

31. What is better? A President who strongly advocates for better health care and gets only incremental

success, or one who wants to maintain the status quo and succeeds?

[trillion]

54. If nothing else he can exercise veto power. How will Hillary do anything? And she won't even try

to change anything. At least Bernie will be fighting for us. Hillary will be fighting for the insurance companies on her super pacs.

[bread_and_roses]

3. But but but - Bernie wants to take away my "good insurance"

You know, the "good insurance" that costs my employer over $1000 a month and is the main reason they can't wait for me to retire. That "good insurance" assures that we pay the highest cost for the worst health outcomes in the developed world.

[CountAllVotes]

18. Yep

And if you have some sort of a problem, they'll happily push you along your way to early Social Security and/or SSDI/SSI.

Then you qualify for Medicare and then they'll have to pay next to nothing for the likes of YOU.

Sickening system isn't it?

[thesquanderer]

5. Yes, we force people to buy health insurance they can't afford to use.

So much of it, then, functions essentially as "catastrophic" health insurance... the kind you *used* to be able to buy more cheaply, before Obamacare said it "wasn't good enough."

[Nay]

21. My son is in this pickle. Family of 3, $530 a month premium, and

a $13,000 deductible. Except for major illnesses and accidents, this 'insurance' is fuckin' useless, and it drains their pockets every month.

[earthside]

29. Same here.

My son is still single, but the new premiums and higher deductible is making him consider just paying the IRS fine ... because he makes just a bit too much to receive any subsidy.

Obamacare is in trouble.

And this is why my son likes Sanders -- because Sanders is talking directly about a problem he is facing.
"First woman president" means absolutely nothing to my son, he wants real solutions to real problems he and his generation are dealing with and Clinton is just not talking about those things in a way that expresses any meaning to him.

My Millennial daughter feels the same way. She is still on our family insurance plan, but the cost of college is becoming a burden on her more and more every day -- Hillary has no message for her whatsoever.


Interesting as I'm typing this it makes me wonder why the Clinton campaign is so surprised that young folks aren't interested in Hillary ... a 74 year old guy from Vermont is speaking directly to their concerns -- who woulda' thunk it?

[Carolina]

47. Bingo!

The ACA is an insurance bonanza that does nothing for healthCARE.

Everyone is paying more for less and avoiding seeking care unless it's 'life or death' necessary

[coyote]

49. That's disgusting

$13,000 deductible? Why have health insurance at all.

[-none]

6. Private health insurance companies are the number one problem with health care in this country.

What do you expect when health insurance lobbyists help write the ACA?
Why does this country have such a problem doing what every other industrialized country has already done. Some form of Single Payer, Universal health care. Other countries got rid of their private health insurance companies and survived. Why can't we?

[CountAllVotes]

9. Why can't we?

Because "we" are projected to have HRC as the next President -- a member of that ilk aka the 1%. We're screwed already and the screwing will get worse the longer this feed the 1% at the trough game continues.

[Mosby]

35. The insurance companies are a symptom

The problem is hospital, equipment and drug costs.

[-none]

43. They can get away with charging like that because they are in bed with the health insurance companie

Hospitals are usually top heavy with needless/redundant administration that need to be paid. And don't forget all that expansion, that gets filled with expensive technology, that needs to be paid for. The same as the other hospital two blocks over. The one that is their main competition.
Getting rid of the private health insurance companies removes a lot of the money going back to the hospitals money trough.
Hospitals need to share their expensive technology with each other, not compete for patients.
Health care should be a Right, not as it is now, an "Your Money, or Your Life" affair, with the health insurance companies in charge of who lives or who dies, to maintain both their own and the hospital's bottom line.
Canada doesn't have this problem. They have mostly private health care and government reimbursement, i.e. Single Payer, for the actual medical costs.

[Recursion]

48. No, hospitals are the number one problem with health care

That's "services" (hospitals and physicians, mostly; see next chart), "stuff" (pharma and devices), and "overhead" (both insurance profit and administration costs).



That's the breakdown of "services". Mostly hospitals and physicians.

[duplex]

10. This is the situation I'm in this year

The only plan I could afford had an 8000.00 deductible. Now I'm just praying that I don't get too sick or have to go to the doctors office for anything. It's depressing and there's no solution in sight for me, unless I can somehow afford 600 dollars a month for insurance. I'm not going to the doctor unless I'm dying or something goes drastically wrong.

[CountAllVotes]

14. If you get sick go to an Urgent Care Clinic

and hope for the best.

If I'd just "let it go" when I thought I had the flu, I'd be dead right now, yes dead. Not that I'm worth two hoots in hell but like it or not I am still around.

So please if you get sick go and get checked at an Urgent Care Clinic if there is one around where you live I beg of you.

As for this great system, yes, it sucks and sucks badly. It is considered to be better than nothing at all so you have to look at it that way unfortunately.

[duplex]

33. Thanks Countallvotes

I will if I have to and I'm glad you pulled through. But any kind of "checkup" stuff is off the table for me now.

[Zorra]

20. The ACA works well for the impoverished. For the rest of us...vote Bernie 2016

and single payer will be great for all of us except for the health insurance corporation vampires.

[Matariki]

22. Mandatory Insurance that you can't afford to use

Who came up with this brilliant plan?

[christx30]

24. The insurance companies. n/t

[CountAllVotes]

30. Someone out to make a killing off of ...

A very fragile segment of our society once known to be THE MIDDLE CLASS!

[Dont call me Shirley]

53. This plan was hatched by the Heritage Foundation. Romney was the first, as governor, to enact it.

[LiberalEsto]

23. Our $4,000 deductible leaves us broke for much of the year.

Last year I put off a much-needed colonoscopy until I was sure we had met the deductible. I had a tiny polyp removed, which meant that this went beyond "preventive" care. I ended up with a $650 bill for the extra anesthesia required for the few seconds it took to remove the polyp.

Little did I realize that the insurance company would contend that it received the anesthesia claim before various medical claims from the previous month, and refuse to cover the $648. I argued about it but there is no way that I can prove when the other medical claims, which I thought had helped meet the deductible, were received by the company. And they knew I couldn't prove it.

These bastards are extremely devious and have figured out loopholes of all kinds to benefit themselves. The current system is better because it covers more people, but it is a huge giveaway to the insurance companies.

[SHRED]

25. My wife and I

We get help via Covered California. Our annual AGI is about 55K.
We pay about $650 per month in premium payment and the copays are pretty high for a silver plan.
They do not cover my wife's expensive physical therapy nor chiropractic. No vision. No dental. All of these are out of pocket.

This is too expensive for our income.

[Elmer S. E. Dump]

32. They forced it on us just this year - $5000 deductible.

Actually, I pay EVERYTHING myself, including absurd drug prices, until I hit $3000 out of pocket. Then I pay 20% of everything until I reach my max out of pocket of $5000. After that, if I'm lucky enough to have any of the year left, everything is free from that point until next January.

[lark]

34. Insurance companies are the devil.

Not only have they raised prices, even though they have so many more members than they did before ACA, they are recategorizing and not covering medicines right and left. BCBS is now denying almost all proton pump inhibitors, including Prevacid and Prilosec, even the generics versions of those. I had a generic rx for Omperazole (generic for Prilosec) filled 11/15 and paid $3.86. Now, BCBS has made all proton pump inhibitors, except one that I've never heard of, non-covered. Luckily for me, as long as I have food with my coffee, I'm OK. My friend at work has an eroded esophagus her reflux is so bad, and they wont pay for hers. She's been really sick all year since she can't get the rx she needs. BCBS doesn't give a fuck, because they, like all of them, are soulless devils.

So between raising the deductibles and not covering needed long existing medicines, they are well and truly screwing us. This is why single payer is so necessary.

[Mosby]

36. Can't you get those over the counter?

On drugstore.com Prilosec is about 75 cents to a dollar each.

[lark]

44. Yes, but that's way more expensive than the perscription.

I paid $3.86 for 30 pills of the generic Prilosec, over the counter it'd cost me up to $30 plus tax. Bloodsucking BCBS doesn't care.

[Mosby]

45. that sucks

It's bizarre that they would remove such a common class of drugs.

[mike_c]

37. it's time for universal public health care....

eom

[Dont call me Shirley]

38. The only way is SINGLE PAYER HEALTHCARE!!!!!!!!!!!

ACA was written by FOR-PROFIT health insurance, pharmaceutical and healthcare companies!!!!!

[TryLogic]

39. US Health Care -- via organized crime?

If organized crime created a health care system, what would it look like? How would it work?

People would have to pay for protection -- call it insurance.

People would be steered into taking drugs that are difficult to stop taking. Once started in drugs (called medicines), they would gradually find themselves taking more and more drugs they could not stop taking.

People would be charged very high prices for necessary medical help such as important tests and procedures. Prices for many medicines would be outrageously high.

The crime bosses would buy and otherwise influence politicians who would then protect them and their profiteering.

Honest doctors would be pressured into helping the mob maximize profits, for example, by not mentioning alternative procedures that would have to be performed elsewhere, or by selling the more expensive surgical procedures and tests that need not be done, and by scaring patients into getting such procedures.

There would be rampant advertising by drug companies to brain wash naive citizens into asking for various drugs that would supposedly provide magical benefits.

[Odin2005]

40. The ACA is a debacle.

The Hillary supporters defending this crap disgust me.

[Skittles]

41. why did you say Hillary supporters?

why not Obama supporters?

[Doctor_J]

42. yep. mine went up again. those of us with company plans are getting killed, sometimes literally

To those who insist we have to pay the insurance companies 20% overhead to get healthcare, please join the republicans.

[Xolodno]

46. It's not just the ACA....

...even major corporations are dropping their HMO's in favor for high deductible plans. The one I work for did.

They do offer a PPO, but the cost is so prohibitive (and what they cover is a joke)...it makes it a giant rip-off.

The good part, wife had a rare issue that nearly cost her life. The high deductible plan covered the bill after the deductible (quarter of a million dollars). I couldn't afford the deductible....so I resigned myself to letting it go to collections...the hospital didn't bother. Also our deductible was considered "met" so all the costly tests, doctors visit's afterward were covered.

But yeah, much like a high deductible on a used car, you are just insuring for a catastrophe.

[roamer65]

50. We need Canadian-style single payor ASAP.

Too many gaps in the ACA and it makes doing your own taxes a pain in the a$$ if you don't have health insurance.

[noretreatnosurrender]

51. Legalized Theft

I have a $6,000 deductible on my employers plan (a non profit). My plan is totally worthless but I'm required to buy it or suffer penalties. The amount of money I spend for premiums I could have used to get cataract surgery. My premiums are pure profit for the insurance company. I'm sure I'm not the only one who pays for a plan they can't use. They say they will pay for "preventive" care but that's really a lie. If I go to the doctor and find out I have something (a cataract) that needs to be treated what good does it do me If I can't afford to treat it? What a ripoff.

[trillion]

52. Me too. Infact, I would guess most of us have that high of a deductible - that we can't afford.