Let’s say you have a serious illness as described below. Supposedly a high deductible will encourage shopping around for the least expensive health care, why?
If your deductible is $2,000 you are going to pay the first $2,000 in charges whether they are one $2,000 MRI or two $1,000 MRIs. You stretch your costs out over the year or you don’t, but in any case, you are going to pay $2,000. If you have a serious illness with high and prolonged expenses, what does a high deductible do other than shift costs to the patient?
Now, if you have minor, more routine illnesses and it’s unlikely you will reach a total of $2,000 in charges, it is in your best interest to use a generic drug, or perhaps skip an office visit or even question a test, but once you are on the road to real health care costs and a serious illness, your primary concerns are elsewhere.
However, this pattern of illness is not what is driving high health care costs. The fact is the high-deductible is not a tool to encourage prudent consumers, but a direct cost-shifting method to save money for insurers (and help your premiums I must add). It is the same as the $100 that was common years ago. For example, when adjusted for health care inflation the 1961 $100 deductible would be $1900.81 in 2014.
I recently reported on the growing number of Charlotte-area employers who are switching their work force to insurance with high out-of-pocket risks. Harriet Gatter, a Charlotte cancer survivor whose high-deductible plan requires her to pay for her annual MRIs, talked about how tough it is to compare costs when no one wants to talk about what they charge.
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