High deductible heath plans maim and kill people

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28. touted as "getting the incentives right", they in fact get the incentives all wrong.

people naively claim that this gets the incentives right by making the patient pay the cost of the health care, so that they will be more selective in their health care decisions.

this is a great example of taking market theory and applying it thoughtlessly where it doesn't belong.

in fact, it gets incentives all wrong.

first, once you hit the deductible, you're fully or mostly covered, so we're back to the traditional "problem" that the patient doesn't pay the cost and has zero financial incentive to turn down expensive procedures and test once the deductible is hit, or is going to be hit that year.

second, and most important, is that the health care decisions in the below-the-deductible range are often the ones you WANT patients to be making! these are the office visits for "i think this might be something but if it's going to cost me hundreds of dollars for a quick visit and a lab test, then i'll ignore it until it gets worse". if everyone's lucky it's just a minor virus that goes away, but if it's something more serious, then it later becomes a very expensive problem that could have been headed off by a simple test.


part of the problem is that the health insurance companies have several big financial incentives to defer costs. first, obviously, they earn interest on money they pay later. but more importantly, the patient might well die or switch to a different carrier before the major bills hit. this is the real flaw and crime with competing health insurance providers. they have a natural incentive to deny proper health care that overall costs people and the economy health and money.

overall they are doing damage to the health of the people in the country while extracting wealth, doing further damage to the health of the country itself.