| I understand that the economists who made this study are not the ones calling the shots on the (bad) way the health insurance business is conducted, but man, they're pretty dense if you take the article at its word. "To health economists, this sounded like good news; they've long theorized that higher deductibles would force down health-care costs. The idea was that higher deductibles would make patients become smarter shoppers: If they had to pay more of the cost, they'd likely choose something closer to the $1,529 appendectomy than the $186,955 appendectomy (yes, some doctors really do charge that much). This would push the really expensive doctors to lower their prices so cheaper physicians didn't steal their business." Even the sloppiest and most cursory examination of human behavior refutes this line of thinking-- patients don't shop around for life-saving medical procedures because they need them urgently or semi-urgently, meaning locations close-ish to home are the only choices, if there's even more than one choice that accepts their insurance. For plastic surgery, sure, whatever. For a bypass? No. I guess this gaping hole in their analysis went unnoticed or somehow explained away by their insufficient economic model. "The new paper shows that when faced with a higher deductible, patients did not price shop for a better deal. Instead, both healthy and sick patients simply used way less health care." I would expect to see more plans converted to high-deductible plans after a finding like this percolates through the insurance companies. This behavior is health insurance working as designed: unused, making a fat profit for the insurers while the patients scrape by until they're in critical condition and can't refuse care for the sake of cost-cutting on their end. This system is evil, and it is intentionally evil for the sake of producing more money. ""I am a little bit surprised at just how poorly patients were able to do when looking at very similar products, like MRI scans, and with a shopping tool," says Kolstad, an economist at University of California Berkeley and one of the study's co-author. "Two years in, and there's still no evidence they're price shopping."" This man is a fool of the highest order, truly an overflowing septic tank of stupidity unparalleled in obliviousness even when compared to a slime mold. How are patients supposed to understand comparisons between medical procedures? "A shopping tool" would be too simplistic, anyway. You need a real doctor to answer questions about care choices. "Workers' health spending dropped, and did so quickly. Average per-patient spending fell from $5,222.60 in 2012 to $4,446.08 in 2013. That's about a 15 percent decline in a single year — and it held true across all types of health services. Between 2012 and 2014, there was a 25 percent drop in emergency room spending, an 18 percent decline in physician office visits, and a 6 percent decrease in mental health services." Great job, the patients have been made sicker as a result of cost-cutting measures. Looking forward to seeing more high-deductible plans. Finally, there is no "shopping around" in the sense these economists mean. Try getting a straight itemized quote for a given medical procedure before you get it. Try comparing that with someone else's quote for the same thing. At this point, you've probably wasted a few weeks on the phone/email trying to finagle these things out of the horrendous systems in place. Then, you can cross reference the results with your insurance benefits, and see how badly you're going to get fucked. Yeah, right. |
Are they confusing deductibles with co-insurance? I know the field is confusing, and that sort of confusion is the only way this study makes any sense.
With a deductible ANY non-routine spending means you go over it. So why bother price shopping? It makes no difference.
With co-insurance you pay a portion of every bill, so in that case price matters.