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High Deductibles make people sicker? Color me surprised. - Elf M. Sternberg
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High Deductibles make people sicker? Color me surprised.
People seem genuinely perplexed by this report about how forcing a more capitalist consumption pattern to health care has led to sick people getting even more sick while consuming even less health care.

The scenario is one of low deductibles vs. high deductibles. Economists expected the patients with high deductibles to seek out competitive medical providers on the assumption that they would want to save money. The punchline to the study is that both groups actually had the same out-of-pocket expenses, since the high-deductibles group were being compensated with an employer-sponsored health savings account.

I don't see why this is a surprise. People are genuinely aware of how much "money" they have, even when it's in an HSA and isn't really "theirs" in a long-term sense, and are reluctant to spend it if they don't have to. This reluctance can even change the definition of "have to" upward.

But more importantly, nobody buys health care the way one shops for other things. Most people have an innate sense of what their weekly food budget looks like. They know the rhythms of income and expenditure on a monthly basis for rent and gas. They learn what it means at an annual pace to pay taxes, refresh their wardrobes, fix up their cars.

But one thing we know is that as we get older, we get sicker. And we have *no experience* to guide us. We can look at other people's numbers all day, but we have no innate feel for the problem ourselves. So we hoard money "just in case this is the year it all falls apart." This is the year cancer raises its fatal head, or a mangling car accident happens in the last fiscal week, or whatever.

This is why I'm for a single-payer system. It keeps people healthy.

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darrelx From: darrelx Date: October 22nd, 2015 03:35 am (UTC) (Link)
I was just in a mangling car accident (4-car pile-up, except my "car" was my motorcycle), and am grateful for my HDHP (high deductible health plan). It covered my 25 days of hospitalization (just came home yesterday), and continues to pay for my in-home healthcare and Rehab therapy. My HSA card is all I need to present to pay for prescriptions and providers wanting copays. This as all paid for by my employer, without a cent deducted from my check. Other plans being offered would have required more out-of-pocket.

There are different health plans to fit different people's needs... HDHP is not a bad thing for some, especially not for me as I rebuild my life.

I do expect 100% recovery, but I have a long road ahead.

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