4 ms·
I have a high deducible plan and think its a good idea that everyone gets one. It means you're much more aware of costs and much more careful. One of the reason
by rb808 7y ago
I have a high deducible plan and think its a good idea that everyone gets one. It means you're much more aware of costs and much more careful. One of the reasons the total US healthcare bill is so high is that many/most people get lots of unnecessary tests, lots of marginally useful procedures and lots of expensive emergency work instead of trying to be healthy in the first place.
Finally having people feel the sting of the bills will hopefully pressure people to change the system that is both very inefficient and overpays doctors, drug companies and hospitals.
- Ididntdothis 7y agoWith employer based insurance and lack of price transparency there is almost nothing the patient can do to reduce costs. You can’t get any upfront pricing, it’s hard to evaluate whether a test is needed, you can’t change insurance. You are giving the patient responsibility for something they have almost no chance to understand.
- MichaelApproved 7y agoOn top of that, it's impossible to shop around for some of the biggest purchases. Broke your leg, now what? Start calling local hospitals to see who offers the best price? It's impossible to be an educated consumer with healthcare. Impossible.
- AnimalMuppet 7y agoWorse: One hospital charges less. Will I get equally good care there? Or is their rate of complications higher? Will I suffer consequences down the road, maybe for the rest of my life? Do I really want the less expensive hospital in that case? How much money is a lower chance of complications worth?
- Ididntdothis 7y ago“Broke your leg, now what? Start calling local hospitals to see who offers the best price?” Any responsible citizen would have received insurance approval and checked out hospitals before breaking his leg. Same applies to car accidents :)
- rhexs 7y agoThis idea would only hypothetically work without Medicare or Medicaid. Right now all it does is squeeze the middle class even more as they’re required to further bare the costs of the ever-rising, all-consuming system. So now the middle class, a large, still-working tax base, is the only group required to ration health-care. I always found that a bit odd.
- MichaelApproved 7y agoThis idea could never work. Never. It's impossible to be an educated consumer with healthcare. Slip, fall and break your leg. Who do you call first, 911 or your local hospitals to price shop?
- mattmcknight 7y agoEmergency care is a small fraction of health care costs.
- MichaelApproved 7y agoPutting aside emergency care, how can you tell what is and isn't medically necessary, as OP suggested patients do? How do patients know what something should and shouldn't cost?
- mattmcknight 7y agoHow do you tell what car repairs are necessary? The cost should be baselined by Medicare.
- MichaelApproved 7y agoI can't tell what car repairs are necessary. I trust my mechanic with years of education and experience to tell me what needs to be done.
- volkl48 7y agoAs with many things, a high deductible plan makes sense in theory and does not work very well for the average person in reality. To walk through some but by no means all of the problems: - The average person is bad with money. Always has been, likely always will be. A high deductible plan only "works" if you hold onto the money you would have spent on higher upfront premiums so that you can directly pay for care if you turn out to need it. The problem is, the average person lives paycheck to paycheck, saw the extra money in their bank account, and spent it. Now they're reluctant to get any care, even when necessary, because they don't have the money and it looks like a new expense. Which leads to worse health outcomes, and more things being put off until they become expensive emergencies. - Few people have the medical knowledge to determine what tests are unnecessary or what procedures are marginally useful. Most people are not in the habit of challenging people who are the experts in the field, who they explicitly went to see for their knowledge. - Even fewer people have that medical knowledge and have the time and energy to spend on navigating near-incomprehensible bureaucracies to actually compare prices, quality of care, etc to try to make an optimal choice. ----------------- The solution to expensive healthcare should not be that everyone needs to become financially disciplined, a domain expert in healthcare willing to challenge authority figures, and to waste large amounts of their own time attempting to provider-shop in a system unlikely to ever make that a simple process. I have a HDHP. I save a bunch of money with it, and unlike the average person, I'm in a position where I can do all those things. I get a relatively optimal outcome, although it still wastes a bunch of my time to navigate. While I personally benefit, I strongly feel that HDHP's are not proving to be a net-positive for the system or society. Here's a recent Bloomberg article basically going through a bunch of those unintended consequences: https://www.bloomberg.com/news/features/2018-06-26/sky-high-deductibles-broke-the-u-s-health-insurance-system https://www.bloomberg.com/news/features/2018-06-26/sky-high-...
- TYPE_FASTER 7y agoFear of bankruptcy shouldn't be a motivator for staying healthy.