Corporate health insurers can use a range of tactics to make it seem that they are offering you more at less cost. One such tactic relies on high deductibles to keep premiums down so that the health plan looks more affordable. A recent EBRI report on employers who offer high deductible plans to their workers confirms that high deductibles can be a huge barrier to care.
EBRI looked at the effect on access to care for people with mental health disorders of a switch from a preferred provider organization to a high deductible health plan. EBRI observed that people with major depressive disorders and anxiety were less likely to get care in high deductible health plans.
EBRI further found that working people with mental health disorders in high deductible health plans used fewer health services of many types. They used fewer office visits, they filled their prescriptions less frequently, they spent fewer days in the hospital and they used emergency rooms less often. Moreover, working people in high deductible health plans also used fewer preventive services, including fewer cancer screenings and vaccinations.
In sum, working people in high deductible health plans saved their employers a lot of money on health care. Workers made the choice to forgo health care services and spend less on health care in a variety of instances. It would therefore stand to reason that the higher the deductible, the greater the barrier to care for people with Medicare, who tend to live on far lower incomes than working people.
EBRI’s findings are in sync with a range of other findings showing that, overall, cost is a barrier to care for people with health insurance. Tens of millions of Americans with insurance are underinsured and live on small fixed incomes. Once out-of-pocket health care costs come into play, they are forced to decide between their health and their rent or mortgage or heat or supper. These are choices that no one should have to make.
A recent NBER study found that more than 20 percent of people with Medicare drop all their prescriptions–including life-saving medicines–when they face a copay increase of as little as $10.40. As a result, thousands die. So, it’s not surprising that high-deductible health plans, with deductibles in the thousands of dollars, lead lots of people to forgo care. Some of these people likely die needlessly as a result.
Congress continues to sit back and let people opt against getting needed health care because of the cost rather than regulating health care prices and guaranteeing access to health care to anyone and everyone who needs it, regardless of ability to pay. Talk about a Darwinian approach that will lead to countless needless deaths and disabilities.
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