And those deductibles renew every year. So for
millions of families, time is running out to fit in those last-minute
healthcare needs. When the clock strikes 12 in just 35 days on January 1, 2022,
they’ll find their healthcare back behind the deductible paywall. It gives
Black Friday a whole new meaning. 

Health insurers argue that deductibles are a
simple “cost-sharing” strategy—forcing patients to have “skin in the game” when
it comes to using healthcare (beyond their actual skin, I guess?).
Cost-sharing, they argue, prevents beneficiaries from using unnecessary,
“low-value” healthcare. They point to an out-dated 1970s-era experiment run by the Rand
. It showed that
patients who had to pay at the point of care did, in fact, use less healthcare,
and that their health outcomes were no different than those who did not have to
pay. The healthcare they forwent, the study suggests, was “low value,” unnecessary

The experiment unlocked a Pandora’s Box of
cost-sharing in health insurance plans. But there’s an obvious difference
between the deductible they tested in the Rand experiment and the ones health
insurers charge today: They are astronomically larger. 

Later studies have shown that deductibles
don’t simply prevent “low value” care, but all care. One study of employees of a company that switched its
coverage from a zero-cost-sharing plan to a high-deductible plan found that
after the switch, their employees even used fewer diabetes medications and got
fewer colonoscopies—high-value healthcare, indeed. Another study found that women who were forced into a high-deductible plan delayed breast cancer screenings. Those who went on to develop
breast cancer had their treatment delayed by an average of nine months!

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