Deductible for health insurance gives Black Friday a whole new meaning

And those deductibles are renewed every year. So for millions of families, time is running out to meet those last-minute care needs. When on January 1, 2022, the clock strikes 12 hours in just 35 days, they will find their healthcare behind the deductible paywall. It gives Black Friday a whole new meaning.

Health insurers argue that deductibles are a simple cost-sharing strategy, forcing patients to have “skin in the game” when it comes to using health care (beyond their actual skin, I guess?). Sharing the costs prevents beneficiaries from using unnecessary, ‘low-quality’ healthcare. They point to an outdated experiment from the 1970s conducted by the Rand Corporation. They found that patients who had to pay at the point of care did indeed use less care and that their health outcomes were no different than those who did not have to pay. The care they denied, the study suggests, was “low value,” unnecessary care.

The experiment unlocked a Pandora’s box for cost-sharing in health insurance. But there’s a distinct difference between the deductible they tested in the Rand experiment and the deductible that health insurers charge today: They’re astronomically larger.

Subsequent studies have shown that deductibles not only prevent “low value” care, but all care. A survey of employees at a company that switched its coverage from a cost-sharing plan to a high-deductible plan found that after the switch, their employees actually used less diabetes medication and received fewer colonoscopies — quality healthcare indeed. Another study found that women who were forced into a high-deductible plan delayed breast cancer screening. In those who developed breast cancer, treatment was delayed for an average of nine months!

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