4 ms·

I hate my HDHP but as far as I can tell it’s ultimately driven by the massive increases in medical care costs. My total premium cost (counting employer contribu

I hate my HDHP but as far as I can tell it’s ultimately driven by the massive increases in medical care costs. My total premium cost (counting employer contribution) is a little more than 20k and I have a 7k deductible. How much higher would the premium be with a more reasonable deductible? You pay one way or another. I agree it’s a huge nightmare dealing with the bills and claims processes, but I’m not sure that goes away with high deductible plans. At the end of the day we have to get medical costs under control and I don’t think there are any great ideas for that right now. Public single payer will help, and it could at least end the billing nightmare, but I don’t see it actually solving the underlying problem of skyrocketing health care costs because the problem is too big and people are too politically invested in the way things are now. The insurance company is coming out ahead on me, even when I had a kid I still paid them more money than they paid out, but a coworker’s wife had a heart attack and had some extraordinary care that the insurance was ultimately paid more than a million dollars for. These major health events and chronic illnesses are completely through the roof in terms of costs.

PaulHoule 8y ago
If HDCP and other plans exist on an open market, then the difference of the cost between them tends to be the amount of the deductible. This is what I have seen on the Obamacare exchange and also in prices for employer provided plans. The reason for that is adverse selection. If you don't expect to go to the hospital then you can save money with the HDHP. Only very sick people will choose the more reasonable deductible.
- Amezarak 8y ago
  In my experience at three different employers the lower deductible plans are more expensive by more than the difference in the deductible. That is, in my experience, it has always been more rational to choose the higher deductible plans because even if I assumed I would always meet the deductible the cost of the deductible plus the premium was always less on the HDHP.
  - uberduber 8y ago
    More or less this. I am a person who exceeds not just the deductible but the out of pocket max more years than not. The out of pocket max on the bronze plan is something like $7k and the out of pocket max on the platinum was still $5k, but the premium difference is $900/mo. There are certainly cases where you come out ahead on the platinum but I think they are unlikely for most people.

PaulHoule 8y ago

If HDCP and other plans exist on an open market, then the difference of the cost between them tends to be the amount of the deductible. This is what I have seen on the Obamacare exchange and also in prices for employer provided plans. The reason for that is adverse selection. If you don't expect to go to the hospital then you can save money with the HDHP. Only very sick people will choose the more reasonable deductible.

Amezarak 8y ago
In my experience at three different employers the lower deductible plans are more expensive by more than the difference in the deductible. That is, in my experience, it has always been more rational to choose the higher deductible plans because even if I assumed I would always meet the deductible the cost of the deductible plus the premium was always less on the HDHP.
- uberduber 8y ago
  More or less this. I am a person who exceeds not just the deductible but the out of pocket max more years than not. The out of pocket max on the bronze plan is something like $7k and the out of pocket max on the platinum was still $5k, but the premium difference is $900/mo. There are certainly cases where you come out ahead on the platinum but I think they are unlikely for most people.