Could higher co pays and deductibles influence bad decision making?

[dkf]

"Patients do make small decisions. Should  I visit the doctor? Should I have my blood pressure checked?  Should I try a smoking cessation clinic? And here, research shows, that if they face a co-pay, there is a 50/50 chance that they will make the wrong decision, foregoing needed care"


http://www.healthbeatblog.com/2009/12/fact-check-the-cadillac-controversy.html

Could it be the reason other countries have lower costs is because there are no cost benefit decisions to be made when seeing a doctor? Could it be that in trying to make patients more aware of costs we are causing higher bills down the line? I know studies on prevention show the extra tests equal the savings so it doesn't cut costs as a whole but that is blanket tests for no detectible ailment. But if a person experiences symptoms and pooh poohs it because of deductibles and copays these are the early warning signs that would bring down future costs if heeded early.

[nightrain]

1. knr. Yes. High co-pays and deductibles are a HUGE deterrent to obtaining

needed care. It's an obstacle to access.

[dkf]

2. Yet we call these Cadillac plans and luxuries.

Difficult insurance companies and all their rules might be obstacles to lower costs not the solution.

[nightrain]

3. hmmm... my understanding is that "Cadillac" plans have lower deductibles and copays though...

Might want to check on that terminology. Although I wouldn't necessarily use Time Mag as a source--- http://www.time.com/time/politics/article/0,8599,1913147,00.html

[dkf]

4. Well that is the general assumption which makes people interested in taxing them for being too

generous.

I just wonder if this "wrong path" isn't what Howard Dean was referring to.

Maybe it's the system that causes high costs and our efforts cannot get us to the goal of lower costs. An expensive inefficient system provides healthy livelihoods.

[nightrain]

6. I hadn't heard what Dean said about wrong path. High costs seem to have

several sources, not the least of which is corporate overhead. Also duplication, fragmentation, papershuffling, paying for deniers of claims, waste and fraud (sm).

Yes, an expensive inefficient system does provide healthy livelihoods, for some.

[bornskeptic]

10. If you're paying $23,000 for group insurance and still paying copays and deductibles,

you're getting ripped off. The threshhold values are determined from the actuarial cost of providing BCBS Standard coverage, such as that of most members of Congress, and eliminating out-of-pocket expenditures. Many people are imagining that they have Cadillac coverage when they don't. Most large group insurance in the US costs under $14,000 for family coverage, far from Cadillac level. I've only had employer-provided coverage from state universities, and I've always been able to read the cost of my health insurance off of each pay stub. I never before realized that people in the private sector didn't even know what their health insurance was costing them and their employer.

[johnaries]

5. Which is why the HCR bills LIMITS co-pays and deductibles.

The one exception is the "Cadillac" plans which have almost no co-pay or deductible, which can also influence bad decision making.

[ProSense]

7. Preventive care is free under reform, the co-pay is eliminated. n/t

[dkf]

9. Preventive care is checkups. I imagine going to the doctor with a suspected ailment is different.

But feel free to correct me if I am wrong.

Would checkups then not trigger any payment for any test or procedure during this exam? Everything is completely free of charge? Are we turning everything into a "Cadillac plan". Sounds good to me if so.

[truedelphi]

8. It has always been a fact that such policies allow for the poorer folks to

Subsidize the richer folks. So we avoid the services, as a co-pay would overbuerden our very limited budget, while still paying hefty premiums, but the person who somehow managed to hold onto a good enough job that they can afford such, their treatment is somewhat covered by our not seeking treatment.