One of the most hotly contested issues in healthcare is whether patients will make more cost-conscious choices if they have a bigger financial stake in the services they receive.
A study released Thursday stoked the controversy further by casting doubt on the concept, a cornerstone of President Bush's plans to reform the country's healthcare system.
For The Record
Los Angeles Times Saturday December 09, 2006 Home Edition Main News Part A Page 2 National Desk 1 inches; 31 words Type of Material: Correction
Health plans: An article in Friday's Business section about high-deductible health plans incorrectly said WellPoint Inc. was the parent company of Blue Shield of California. WellPoint owns Blue Cross of California.
Many Republicans and the insurance industry argue that offering health plans with low premiums and high deductibles would go a long way toward reducing costs. Such plans would make insurance more affordable while giving people an incentive to take better care of their health and cut unnecessary expenses.
Opponents say such plans, which insure more than 10 million people by some estimates, exploit those who can't afford more comprehensive coverage.
The stakes are high as the newly empowered Democrats, who are generally cool to the idea, vow to make healthcare a top issue.
Whether high-deductible plans are a "success or failure will say a lot about the fundamental healthcare reform we will have in this country," said Robert Laszewski, president of Washington-based Health Policy and Strategy Associates Inc.
But the evidence so far is inconclusive, in large part because high-deductible plans are still very new and generally estimated to account for less than 10% of the market.
Although premium differences between high-deductible and conventional plans vary, the savings can be significant. For example, monthly premiums on a Blue Cross of California plan for nonemployer-sponsored individuals with a $3,500 annual deductible range from $55 to $259. A comparable plan with a $500 deductible costs $225 to $643.
The high-deductible concept took hold after Congress passed the Medicare Modernization Act of 2003, which allowed people with so-called consumer-driven health plans to open tax-sheltered savings accounts earmarked for medical expenses.
According to a report released Thursday by the Commonwealth Fund and the Employee Benefit Research Institute, two of the country's most prominent voices on healthcare issues, high-deductible plans do little to grow the ranks of the insured and may be keeping people from getting needed care. People in high-deductible plans reported being more likely to postpone care or skip it altogether because of concerns about the expense.
