Cost sharing is bad for your health
Center for Studying Health System Change (HSC)
News Release
Dec. 12, 2003
Health Care Spending Growth Slows Sharply in First Half of 2003
Health care spending growth per privately insured American slowed in the first half of 2003, increasing 8.5 percent, a sharp drop from the 10 Percent increase in the second half of 2002, according to a Center for Studying Health System Change (HSC) study released today.
“Increased patient cost sharing is probably an important factor in the slowing of cost trends, but few experts expect this tool to substantially lower cost trends over the long term,” said Paul B. Ginsburg, Ph.D., coauthor of the study and president of HSC, a nonpartisan policy research organization funded exclusively by The Robert Wood Johnson Foundation.
“Without more effective cost-control measures, the rising cost of health insurance will make coverage unaffordable to more and more Americans,” Ginsburg said.
“As patients are having to share more of the costs, the fact is that more and more patients go without care,” said Paul Ginsburg, president of the Washington, D.C.-based center (Agovino, Associated Press).
HSC release
http://www.hschange.com/CONTENT/634/
Associated Press article by Teresa Agovino:
http://www.chron.com/cs/CDA/ssistory.mpl/health/2289043
And…
The New England Journal of Medicine
December 4, 2003
The Effect of Incentive-Based Formularies on Prescription-Drug
Utilization
and Spending
By Haiden A. Huskamp, et al
In conclusion, we found large effects on the continuation of the use of medications and out-of-pocket expenditures for enrollees associated with the switch by one employer from a one-tier to a three-tier formulary involving across-the-board increases in cost sharing… The discontinuation of the use of medications such as statins and ACE inhibitors that are needed for the treatment of chronic illnesses raises important questions about potentially harmful effects of formulary changes and the associated changes in copayments.
http://content.nejm.org/cgi/content/abstract/349/23/2224
Comment: In order to control the premium increases in private health plans, insurers are reducing benefits and increasing cost sharing.
Conservatives contend that it is essential to make patients sensitive to cost so that they will make wise financial decisions on the care that they really need. Unfortunately, since most patients with significant health care needs have little disposable income, the only real choice that they will have is to do without. Innumerable studies have now confirmed that increased cost sharing
significantly reduces the utilization of beneficial health care services.
The health savings accounts (HSAs) which will go into effect next month will help neither those who deplete their accounts because of chronic disorders
nor those who are unable to fund their accounts. Insurance premiums for these less fortunate individuals will be made affordable only by reducing benefits and increasing cost sharing.
Ironically, those who are able to build large HSAs are precisely those who have the least health care needs. Neglecting the ill to benefit the healthy is not rational health policy.
No matter what we do, under the present fragmented system of funding care the increased trends in cost sharing will make health care unaffordable for moderate and low income individuals with significant health care needs.
The experiment with cost containment through greater cost sharing has already failed miserably when measured by its impact on those with greater needs.
Let’s abandon these perverse efforts and move forward by adopting an equitable, comprehensive, universal system of social insurance. That Will work.