Wed Jan 20, 2016, 07:41 AM

eridani (51,907 posts)

Higher deductibles do NOT lead to more careful "shopping"

http://archinte.jamanetwork.com/article.aspx?articleid=2482348

During their last use of medical care, HDHP enrollees were no more likely than enrollees in traditional plans to consider going to another health care professional for their care (n = 120 [10.9%] vs n = 85 [10.0%]; P = .67), or to compare out-of-pocket cost differences across health care professionals (n = 42 [3.8%] vs n = 23 [2.7%]; P = .37).

Simply increasing a deductible, which gives enrollees skin in the game, appears insufficient to facilitate price shopping. Members of HDHP and traditional plans are equally likely to price shop for medical care, and they hold similar attitudes about health care prices and quality.

http://archinte.jamanetwork.com/article.aspx?articleid=2482346

It is true that high-deductible health plan enrollees have “skin in the game.” However, these enrollees are exposed to substantial out-of-pocket cost risk with little evidence that this risk exposure will incentivize higher-value health care decisions, meaning they are essentially playing the game blindfolded with one hand tied behind their back.

Comment by Don McCanne of PNHP: This study shows that individuals with high-deductible health plans (HDHP) are no more likely to select their care based on their out-of-pocket costs than do individuals enrolled in traditional health plans without high deductibles. As the editorial states, it is likely that “getting enrollees to make higher-value decisions remains a mirage.”

So high deductibles do not cause patients to be smart shoppers, but they do cause patients to decline beneficial health care services. They also create financial hardships for some patients.

Thus high deductibles have a net negative impact. We should get rid of them. A single payer system is a much more efficient and patient-friendly method of controlling health care spending

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11 replies	Author	Time	Post
Higher deductibles do NOT lead to more careful "shopping" (Original post)	eridani	Jan 2016	OP
Who the hell wants to go shopping for medical treatment?	Human101948	Jan 2016	#1
Exactly. Makes no more sense than "shopping" for a fire department	eridani	Jan 2016	#2
If they can even tell you, it will depend	Habibi	Jan 2016	#9
HEALTH CARE IS NOT A COMMODITY	Warren Stupidity	Jan 2016	#3
I don't understand this at all. "Price Shopping?"	StandingInLeftField	Jan 2016	#4
Ridiculous. My doc says I need a colonoscopy, how do I price shop? The hospitals and docs	peacebird	Jan 2016	#5
Pfft. We peons don't deserve to look at qualifications and outcomes.	jeff47	Jan 2016	#6
ACA: it's the best we could hope for!	KG	Jan 2016	#7
It's a start--let's take it further n/t	eridani	Jan 2016	#8
So you're laying on a gurnery at the ER and you've just been told you need bypass surgery.	Vinca	Jan 2016	#10
Deductibles are designed to provide a period of 100% profit until a claim is made and then the	Monk06	Jan 2016	#11

Response to eridani (Original post)

Wed Jan 20, 2016, 07:47 AM

Human101948 (3,457 posts)

1. Who the hell wants to go shopping for medical treatment?

Last edited Wed Jan 20, 2016, 09:26 AM - Edit history (1)

When you think about how important people feel that is to "keep your own doctor," the idea that they would go "shop around" is ludicrous.

And I haven't tried it myself but what's the response when you call up a specialists and ask for pricing?

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Response to Human101948 (Reply #1)

Wed Jan 20, 2016, 07:51 AM

eridani (51,907 posts)

2. Exactly. Makes no more sense than "shopping" for a fire department

Public goods work differently from market goods.

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Response to Human101948 (Reply #1)

Thu Jan 21, 2016, 08:25 AM

Habibi (3,576 posts)

9. If they can even tell you, it will depend

on a number of factors: whether you're a new patient, what your complaint is, what location you'll be seen at, type of procedure (if needed), and the location of that.

Also, with mega-hospital corps buying up small practices, it's hard to tell if "shopping" is even worth it (to those that have the time to spend calling around).

High deductible plans (and they all seem to be high-deductible now) don't motivate me to shop around, they motivate me to not get care. Period.

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Response to eridani (Original post)

Wed Jan 20, 2016, 07:54 AM

Warren Stupidity (48,181 posts)

3. HEALTH CARE IS NOT A COMMODITY

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Response to eridani (Original post)

Wed Jan 20, 2016, 09:11 AM

StandingInLeftField (972 posts)

4. I don't understand this at all. "Price Shopping?"

Every insurance package I've ever encountered requires that you stay in-group or go it alone. This is asinine.

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Response to eridani (Original post)

Wed Jan 20, 2016, 10:11 AM

peacebird (14,195 posts)

5. Ridiculous. My doc says I need a colonoscopy, how do I price shop? The hospitals and docs

Do not have prices listed on a 'menu' so I can compare.

Plus, when looking for a cancer doc, I look at qualifications and who has best outcomes, not lowest cost.

The whole "skin in the game" arguement is total bs. What they want to do, in reality, is make it so expensive people DO NOT seek treatment so that the insurance never has to pay out!

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Response to peacebird (Reply #5)

Wed Jan 20, 2016, 12:43 PM

jeff47 (26,549 posts)

6. Pfft. We peons don't deserve to look at qualifications and outcomes.

We're supposed to get our treatment from DocMart. I hear Doctor Nick is running a sale.

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Response to eridani (Original post)

Wed Jan 20, 2016, 02:21 PM

KG (28,729 posts)

7. ACA: it's the best we could hope for!

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Response to KG (Reply #7)

Thu Jan 21, 2016, 06:46 AM

eridani (51,907 posts)

8. It's a start--let's take it further n/t

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Response to eridani (Original post)

Thu Jan 21, 2016, 09:15 AM

Vinca (49,166 posts)

10. So you're laying on a gurnery at the ER and you've just been told you need bypass surgery.

At that point they think you should go price shopping??????????????? Bottom line, most people do not have the expertise or time to evaluate the quality or type of medical service they require versus the cost from numerous providers. Stop the madness. Medicare for all.

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Response to eridani (Original post)

Thu Jan 21, 2016, 09:38 AM

Monk06 (7,675 posts)

11. Deductibles are designed to provide a period of 100% profit until a claim is made and then the

'enrollee' is priced out or denied ensurance outright.

It's a shell game. three card monti, ring toss at a carni sideshow

Fraud pure and simple

Until single payer run federally is instituted, the US does not have a modern health insurance system.

The insurance industry must be cut out of the medical insurance business for basic care, cronic healthcare and surgery just like the UK and Canada. The private market can have the breast enlargments and face jobs

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