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Latest Research

Patients with chronic obstructive pulmonary disease and high deductible health plans forgo needed care because of cost, struggle to pay medical bills, and face worse health outcomes: Harvard study

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October 10, 2019

Contact: Clare Fauke, Physicians for a National Health Program, 312-782-6006 or clare@pnhp.org

Patients with chronic obstructive pulmonary disease (COPD) and private high-deductible health plans face “financial toxicity” due to health care costs, forgo needed care because they are unable to afford it, and wind up in the ER and hospital more often than those with traditional health plans, according to a new study from Harvard researchers published today in the Annals of the American Thoracic Society.

In this national study, the researchers found that 29% of individuals with COPD and a high deductible avoid or delay needed health care because of cost, while one in five take less medicine than needed in order to save money — significantly more than those with “traditional” plans with no or low deductibles.

The researchers also found that high-deductible plans strained family finances for those with COPD: 21% of these individuals have family out-of-pocket annual medical spending exceeding $5,000, about a third struggle to pay family medical bills, and about half worry about being able to afford their regular health care.

Those with high-deductible health plans were also hospitalized more frequently than those with traditional low- or no-deductible plans, they found, and wound up in the ER more often. These findings suggest that forgone or delayed preventive care could be having harmful health effects.

“COPD is not an easy disease to live with,” noted lead author Dr. Adam Gaffney, a pulmonary and critical care physician and an instructor in medicine at Harvard Medical School and president of Physicians for a National Health Program. “But treatment can help, assuming patients can afford it. Yet our study shows that patients with COPD who are privately insured, especially those with high deductibles, aren’t getting the care they need — with dangerous consequences for their health.”


“High deductible health plans and health care access, use, and financial strain in those with COPD,” Adam Gaffney, M.D., M.P.H.,  Alexander White, M.D., Laura Hawks, M.D., David Himmelstein, M.D., Steffie Woolhandler M.D., M.P.H, David C. Christiani, M.D., Danny McCormick, M.D. Annals of the American Thoracic Society, published online October 10, 2019.

Physicians for a National Health Program (www.pnhp.org) is a nonprofit research and education organization whose more than 23,000 members support single-payer national health insurance. PNHP had no role in funding or otherwise supporting the study described above.

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