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Showing Original Post only (View all)High deductible heath plans maim and kill people [View all]
The Impact of High-deductible Health Plans on Men and Women: An Analysis of Emergency Department Care
http://journals.lww.com/lww-medicalcare/Abstract/2013/08000/The_Impact_of_High_deductible_Health_Plans_on_Men.2.aspx
Background: Prior studies show that men are more likely than women to defer essential care. Enrollment in high-deductible health plans (HDHPs) could exacerbate this tendency, but sex-specific responses to HDHPs have not been assessed. We measured the impact of an HDHP separately for men and women.
Methods: Controlled longitudinal difference-in-differences analysis of low, intermediate, and high severity emergency department (ED) visits and hospitalizations among 6007 men and 6530 women for 1 year before and up to
2 years after their employers mandated a switch from a traditional health maintenance organization plan to an HDHP, compared with contemporaneous controls (18,433 men and 19,178 women) who remained in an health maintenance organization plan.
Results: In the year following transition to an HDHP, men substantially reduced ED visits at all severity levels relative to controls (changes in low, intermediate, and high severity visits of -21.5% [-37.9 to -5.2],-21.6% [-37.4 to -5.7], and -34.4% [-62.1 to -6.7], respectively). Female HDHP members selectively reduced low severity emergency visits (-26.9% [-40.8 to -13.0]) while preserving intermediate and high severity visits. Male HDHP members also experienced a 24.2% [-45.3 to -3.1] relative decline in hospitalizations in year 1, followed by a 30.1% [2.1 to 58.1] relative increase in hospitalizations between years 1 and 2.
Conclusions: Initial across-the-board reductions in ED and hospital care followed by increased hospitalizations imply that men may have foregone needed care following an HDHP transition. Clinicians caring for patients with HDHPs should be aware of sex differences in response to benefit design.
http://journals.lww.com/lww-medicalcare/Abstract/2013/08000/The_Impact_of_High_deductible_Health_Plans_on_Men.2.aspx
Background: Prior studies show that men are more likely than women to defer essential care. Enrollment in high-deductible health plans (HDHPs) could exacerbate this tendency, but sex-specific responses to HDHPs have not been assessed. We measured the impact of an HDHP separately for men and women.
Methods: Controlled longitudinal difference-in-differences analysis of low, intermediate, and high severity emergency department (ED) visits and hospitalizations among 6007 men and 6530 women for 1 year before and up to
2 years after their employers mandated a switch from a traditional health maintenance organization plan to an HDHP, compared with contemporaneous controls (18,433 men and 19,178 women) who remained in an health maintenance organization plan.
Results: In the year following transition to an HDHP, men substantially reduced ED visits at all severity levels relative to controls (changes in low, intermediate, and high severity visits of -21.5% [-37.9 to -5.2],-21.6% [-37.4 to -5.7], and -34.4% [-62.1 to -6.7], respectively). Female HDHP members selectively reduced low severity emergency visits (-26.9% [-40.8 to -13.0]) while preserving intermediate and high severity visits. Male HDHP members also experienced a 24.2% [-45.3 to -3.1] relative decline in hospitalizations in year 1, followed by a 30.1% [2.1 to 58.1] relative increase in hospitalizations between years 1 and 2.
Conclusions: Initial across-the-board reductions in ED and hospital care followed by increased hospitalizations imply that men may have foregone needed care following an HDHP transition. Clinicians caring for patients with HDHPs should be aware of sex differences in response to benefit design.
Comment by Don McCanne of PNHP: One of the most important changes in health care financing taking place today is the tremendous surge in the use of high-deductible health plans. This is yet one more study that shows that we should question the wisdom of this policy intervention.
Males whose employers switched them from a traditional HMO to high-deductible health plan reduced their use of emergency department high-severity visits by 34 percent. That is, they did not go to the emergency department when the severity of their condition clearly warranted it. That was followed a year later by a 30 percent increase in hospitalizations. Lead author Katy Kozhimannil stated, "The trends suggest that men might have put off needed care after their deductible went up, leading to more severe illness requiring hospital care later on" (American Medical News, Aug. 26).
High-deductible health plans not only cause financial hardship, they also maim and kill people. And they aren't even necessary as a means to control spending. We can control costs more effectively and far more humanely through a publicly-administered single payer program that provides first-dollar coverage.
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Placing bets on whether or not serious health care expenses will fuck you over--
eridani
Aug 2013
#17
Yes--I want to take it to put it into the general pool which would fund health care for ALL
eridani
Sep 2013
#81
Current law alllows the deductibles in these plans to be just over $6000 annually (single coverage)
dflprincess
Aug 2013
#52
I have a high deductible plan with a health savings account...I love it.
DisgustipatedinCA
Aug 2013
#18
The 85% who pay insurance premiums that will mostly cover OTHER people are colluding
pnwmom
Aug 2013
#35
Are you aware that medical bankruptcies are sharply down since Romneycare was enacted
pnwmom
Aug 2013
#38
The problem with that study and others is that medical costs are usually only a part
pnwmom
Aug 2013
#44
You don't get it. If you lose your job you can STILL go bankrupt even if you have Medicare.
pnwmom
Aug 2013
#48
Only if you live in a state accepting Medicaid money and agreeing to the expansion
eridani
Aug 2013
#62
Then you re-sign up. I'm sure you're not the first person who thought of that question -- it's
pnwmom
Aug 2013
#69
Once you are on Medicare, you STAY on Medicare. Your eligibility doesn't change
eridani
Sep 2013
#83
Are there any groups pushing for that in Washington? I'd be happy to support them. n/t
pnwmom
Sep 2013
#87
Thanks! Maybe you should try to get the word out about the work being done by these orgs
pnwmom
Sep 2013
#89
If this fails that will be the end of any more experiments for decades. Forget single payer.
pnwmom
Sep 2013
#91
Agreed. If other states get on board with single payer, the chances of it spreading improve n/t
eridani
Sep 2013
#93
touted as "getting the incentives right", they in fact get the incentives all wrong.
unblock
Aug 2013
#28
No, they aren't for everybody. They are a bonus point system for the healthy and
eridani
Aug 2013
#64
Like to take a guess as to what the average monthly malpractice premium is in--
eridani
Sep 2013
#77
Oh BS, thankfully we did not have a lifetime limit on our policy and ...
slipslidingaway
Aug 2013
#60