Alison Galbraith and colleagues have produced a nice Health Affairs paper whose title kindof speaks for itself: “Nearly half of families in high-deductible health plans whose members have chronic conditions face substantial financial burden.”
I don’t have time to offer detailed commentary today. Fortunately Aaron Carroll has already written much of what I would have said–had I thought of it, anyway. The basic story is illustrated in one key figure, which Aaron constructed from their paper:
Aaron’s bottom line is similar to mine:
I think that shifting more and more people to high-deductible plans as a blanket solution to our health care system’s ails is a bad idea. It will result in much cheaper rates for healthy people and may seem like a great idea initially. But it will likely cause harm to sick people and people with chronic conditions, the very people I’d argue the health care system is for. There’s likely a place in the health care system for the use of cost-sharing as an economic incentive, but I don’t think it should be the overall philosophy.