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Sick Californians may be forgoing care because health deductible is too high, study says

Three million Californians are enrolled in high-deductible health insurance plans because they can’t afford to pay high premiums.

But the often excessive out-of-pocket costs could be causing some to delay seeking care, while jeopardizing the financial well-being of others, a new report from the UCLA Center for Health Policy Research has found.

The report profiles California’s nearly 32 million insured residents and is based on data from the  California Health Interview Survey, conducted from 2003 to 2007, the largest statewide health survey conducted in the United States, according to the university health policy research center.

According to the report, high-deductible health plans are particularly prevalent among members of preferred-provider organizations, or PPOs, where 28% of participants reported being responsible for out-of-pocket expenses of more than $1,000. But costs can run as high as $2,000 or more for families and can exceed $5,000, the report found. Meanwhile, 14% of members of health maintenance organization plans, or HMOs, are enrolled in high-deductible plans, the report shows.

Low-income residents were more likely to have health plans with excessive out-of-pocket costs — as were 32% of low-income earners enrolled in PPOs, the report found. And some 38% of those individually insured, with no employer-based healthcare coverage, were also members of high-deductible healthcare plans.

Researchers also uncovered a connection between high out-of-pocket expenses and a reluctance to seek care. The majority of participants in high-deductible plans, for example 80% of Kaiser HMO members, reported that they did not have any savings account for medical expenses, according to the report.

The findings come as California establishes a new “health benefits exchange,” as part of recently enacted federal healthcare legislation. The exchange will provide insurance to the state’s uninsured, and under the law, out-of-pocket deductibles will be capped at $2,000 for individuals and $4,000 for families.

-- Ann M. Simmons


Comments () | Archives (40)

But did they delay buying the big-screen tv, cigarettes, alcohol and a new car? No they did not. That's why they dont have money for the deductible.

Oh, no. We don't need health care reform!

My open enrollment for next year just began and the cost went up about twenty dollars a month and the deductable went from 600 to 800 dollars next year. It will mean I have almost $1,800 in costs before my insurance pays anything. Medical costs keep going up and up, but unlike consumer items the price goes up and up. In American, we spend much more on medical care with fewer results than European nations. Doctors and health insurance executives get rich while the middle class in this country is disappearing.

I went to emergency on the advice of my personal doctor (ekg taken in his office was abnormal). I was kept for three days, and nothing found other than a medication adjustment. I paid $100.00 for emergency admittance. I later received a bill for $1200.00 for my stay. I found that my carrier only pays 90% of hospitalization.
I would hate to see if something was really wrong!!!!!

At last! The perfected healthcare system, available to everyone who can pay the deductibles they can't afford.

Just as members of religious organizations set aside tithing funds (many contribute 10% of their income), all of us are wise to budget for essential items. Your health is one of the most important things you have. If you've got an annual deductible of $1,000, then you should plan on spending several hundred dollars each year on the deductible and set aside additional funds to build a stash up to around $2,000 over time just for deductibles (in case something happens late in the year and continues into the next).

The car will also break down and appliances will fail and clothes will need to be replaced. Once you budget for all of these things, many find that they should reduce some less essential expenditures.

Many high deductible plans pay for basic care at 100% and have a health saving account. I wonder what plans they have.

Dear Joe,

You assume you know everything about everyone. What arrogance you show!

Best regards,

Dear Rush,

You clearly didn't read the article. The study was conducted from 2003 - 2007.

Best regards,

So what you are saying is that just because you have health insurance does not mean you can get medical care you need? Next thing you know we're going to have another tax that goes to pay people's deductibles.

genius. so they prove that people cannot afford $1,000 so they cap deductibles at twice that? wouldn't you have thought that maybe HALF the cost of the currently unaffordable deductibles would have been better?

and why wasn't a key feature of healthcare reform STANDARDIZATION AND PUBLICATION OF RATES AND FEES by providers? there is literally NO way to comparison shop because nobody will ever tell you what something will cost you until after. sorry, but medical services aren't sooooo specialized and precious that they cannot quantify them like all other products and services. there is no chance that we can have a healthy economy in healthcare goods and services without standardization, reviews, and price comparisons.

The "Axis of Tax U.S." (Reid, Pelosi and Obama) have cut our Medical Flex-Spend Accounts from $5k to $2.5k and the new law will not allow for the use of Medical Flex-Spend dollars for OTC drugs like, aspirin cough syrup, antihistimines, etc., while co-insurance and deductibles have risen dramatically, with the passage of Obummercare.

On 2 November, we'll give King Obonehead something to think about- CHANGE!!!

The deductible is only part of the problem. Look at your policy for the out-of pocket maximum. Fine print- does not include prescriptions. Try budgeting for anti rejection drugs for a transplant patient! These can run into thousands of dollars per month. Just the insurance companies gouging out their profits before all the reforms take place.

I haven't been to the doctor in years :(

We are a materialistic society with little concern for the real needy. We don't need ten pairs of shoes, or six jackets or coats we rarely use, or a big screen TV, or cigarettes, or booze, or lottery tickets, or an expensive car or house to keep up with the Joneses or not. Get back to basics (reading, writing and arithmentic), and being good, and budget for life's essential (medical and dental insurance) and help the poor and needy in your local community.

Well, what do they expect???

My insurance just went up this month. I now pay over $250. per month out of my full time paycheck and the coverage just gets worse every year. I don't know who this Obamacare is helping, but it's not the working class. What a shock. And then there's the co-pays and other added expenses...

I think I will try to get as much done this next year - as far as preventative care goes - and cancel it next year. It's not smart, but I don't now what else to do.

As I read this I thought - duh, was this supposed to be groundbreaking research... a lot of the people I know - college educated with full time jobs don't have a savings for medical expenses - most don't have a savings. When I was starting out, my check for a full time job out of college wasn't enough to cover rent, gas and groceries in LA. And no, I didn't buy a big-screen TV, cigarettes or a new car. We can all say people need to budget better but I know a lot of people that work pay check to pay check and they are really just getting necessities. And on the point of not getting treatment, I have decent insurance and a savings and I still think ugh... I'm not that sick... because I don't want to spend the $30 on a copay, $15 on parking and take the hour or more out of the day to go.

Though, I don't think the healthcare bill is the answer - healthcare is too expensive, so for insurance companies to stay in business they have to raise the prices. So the answer is to protect hospitals and doctors from huge lawsuits and then maybe outpatient surgeries won't cost $70,000. Forcing every American to get insurance isn't going to solve the problem either - because it will be just like car insurance where a large percentage of Angelenos are uninsured - how do they enforce it? There are illegal aliens on every corner in LA - they can't enforce that... you're telling me they are going to track down every adult without insurance?

auto insurance deductibles are accepted. and so is the implied deductible of your "insurance going up" when you get tickets. the effect of this is to make people really careful about their cars when they drive.

same thing should happen with health insurance. the deductibles are doing exactly half of what they're supposed to be doing (discouraging trivial claims). they aren't doing the other half (changing behavior, in other words giving people an incentive to live healthier because, basically, it's still not economically sensible to spend time and effort exercising and eating food that doesn't taste as good as the sugary salty yummy fat stuff.

the free preventive stuff is up to the medical insurance companies to push, the same way that auto insurance companies encourage safe driving with rebates for good behavior.

people care more about their property in this country than their bodies, but that's normal, because the whole point of a modern society is you don't have to live in discomfort. the cost of comfort is, in the end, having to pay to keep yourself alive once you are sick from being sedentary and eating poison.

"Researchers also uncovered a connection between high out-of-pocket expenses and a reluctance to seek care."

What do the "researchers" conclude about low or zero out-of-pocket expenses? If that encourages them to seek care does that not increase demand? Does not increased demand lead to increased prices?

Ever wonder why college tuition and medical care have outpaced inflation for decades? It's because "somebody else" pays the bills.

Of course Joe,
Low income people should just spend all their money on medical insurance and eat Top Ramen. That's what life is for, right? Paying medical costs? Having no life at all worth living except for Insurance companies. No sports. No health food. No movies. No TV. No music. No beer. Just medical bills. Right?

You are yet another myopic, unwitting shill for pernicious, corporate hegemony. I hope you don't get sick and burn through your payout limit, then have to sell your home. If Big Insurance has their way, that will happen more and more.

Wake up!

The US pays 3X per capita more than every other civilized western country.

We rank 50th in life expectancy.

We rank 27th in infant mortality.

We have the only profit-driven "healthcare" system.

Apparently amerikans aren't math or logic majors. The world has learned the lesson. We are too arrogant to believe anyone else has an answer.

Mencken's line about no one going broke underestimating the intelligence of the amerikan consumer is embodied in the healthcare system.

Isn't this a good result? If everyone were to get whatever medical care they wanted for free, demand would skyrocket and costs would go more through the roof even more than they are now. The deductible forces them to make economically rationale choices about what they want to spend their money on and how much their health matters to them. If anything, the deductibles are probably too low, and should generally be geared to a percentage of income. Most of these people are adults, and are grown up enough to make their own decisions.

The problem with Obamacare is that it largely removes these cost checks. If I pay for health care up front in an all-you-can-eat system, I'm going to be encouraged to consume more, which drives up demand, which Econ 101 tells you drives up the price for everyone.

RE: Drivel from Posted by: Gting of Isn't this a good result? If everyone were to get whatever medical care they wanted for free, demand would skyrocket" OH YEAH!! The colonoscopy was so much fun, they will go have one a month! Nitwit. The median household income with an average of 2.65 people is $50,000 a year. So out of that go pay for housing, food, transportation and other basics and then try to find room for another $1000 or more per person for the deductible. (And then add on the copays which are ususally 20-30%.) 88% of workers make LESS than $75,000 and 50% make LESS than $32,000. The money ain't there for premiums, copays, deductibles etc.

If you think it's bad now wait tell Obamacare takes full effect. Of course we will not habe to wait much longer for Californians to have less money when AB 32 takes effect in Jan 1 there will be less jobs and higher energy bills. So you you need to save your money so you can move to another state to find work. Or you can vote YES ON PROP.23. That will save about 1million jobs in our state.

Take vitiams everyday and eat healthy foods and that will keep you healthy. There is a DVD out call foodmatters watch it may save you a lot of money and keep you healthy if you follow what it says it is worth seeing. Of course the Ins. and drug industries dosn't really want you to know this it will cut them off at the knees.

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