High Deductibles are More Common
The growing prevalence and amount of deductibles has resulted in an increasing percentage of covered workers enrolled in a plan with high deductibles. In 2012, about a third (34%) of covered workers were enrolled in a plan with a deductible of a $1,000 or more compared to 10% in 2006, and 14% were enrolled in a plan with a deductible of $2,000 or more compared to 3% in 2006. The percentages of workers include workers who are enrolled in a high deductible plans with a savings account (HDHP/SO), such as an HSA or an HRA, and those who are in a plan without a savings account.
Source: Kaiser Health News.
I have noticed these types of stories more and more as of late. Indeed, the average deductible for health plans has about doubled over the past decade.
Public health advocates will lament that this is a bad trend because people are missing out on needed care. Purportedly, high-deductibles and cost-sharing are perverse incentives to accessing care in time of need — especially for the poor who tend to have more health needs than the rich. But, there is a limit to how much medical care we should consume even if more care is beneficial at the margin. As John Goodman has pointed out numerous times in the past, we could spend our entire GDP on medical care in useful ways. But that would leave few resources to use towards other areas in which we consume. High-deductible plans allow us to balance our consumption spent on health care as a proportion of all consumption. The competition for consumer dollars that cost-sharing creates would also help consumers get a better deal for the dollars they spend.
This is really interesting — if this trend continues, I bet even MORE people will opt for the HSA. If you’re going to get high-deductible coverage either way, you might as well couple it with a sane, sensible plan like the HSA.
I find the trope, about “missing needed care” really tiring. Who gets to define what is needed? The doctors, the patient, the insurance carrier, some other party? If a person chooses to skip annual exams and is otherwise healthy, has he missed needed care? If a person gets sick, never makes it to the doctor, but feels better after a few days; has he missed needed care?
I agree with Cindy, why not participate in a HSA? They are far more sensible, especially if you have a high deductible.
“poor who tend to have more health needs than the rich”
Health resources are available to both social classes, the difference in education and health programs can affect the wellness of each person. For example, Head start shows personal hygiene for low-income children, where higher income children are shown personal hygiene habitats at home. Constant positive reinforcement for both social classes can benefit these children thought their adulthood. Most likely the higher income children will have less dental problems, where lower income children will not carry habitat learned in Head start. This will then lead to cavities and missing teeth.
HSAs for workers enrolled in high deductible plans makes sense.
However, because these deductibles are doubling each year, people are more and more discouraged to receive treatment for anything. Even just visit their doctor for a regular consultation. This only makes it harder for the poor to receive care, so who’s benefiting from this exactly?
I want to add to what Erik was saying about dental hygiene. The Wall Street Journal did a big feature about the uninsured about six years ago. What really stood out were the interviews with the different uninsured and their wishes about how to improve their access. Not all of them felt like they needed health insurance, but all of them said that they wished they had dental insurance. They could usually make do on other healthcare issues via medicaid, friends, family, charity, et al. But the thing that never gets handled is dental care. And this jives with my own experience with the uninsured, almost all of them have bad teeth and untreated dental problems.
this is a troubling trend
A “general deductible”? That seems ridiculous.
I’d like to see how the healthcare market responds to the increase in these plans. Hopefully with more competitive pricing.
Bad teeth are like a lifetime sentence in terms of personal appearance at least, and leads to ongoing health problems in some cases.
The amounts of money that are spent on one premature baby or one child with a defective heart could provide dental care for hundreds of poor children.
This cries out for a federal program, in my opinion.
I see zero evidence that the dental profession will undertake universal care, without some amount of federal funding and prompting.