That kind of "cost sharing discourages people from using services," said Gary Claxton, Kaiser vice president and co-author of the benefits study. "The more cost sharing there is, the more it's going to be discouraged. And when they are already worried economically, that's got to amplify the effect."
But small-business owners are struggling to find ways to control the escalation and stay afloat, said Michelle Dimarob, legislative affairs manager for the National Federal of Independent Businesses.
"This is very reflective of the tough economic times we're in," she said. "Healthcare is truly a pocketbook issue for both employers and employees."
The trend toward higher deductibles could, in the long run, drive costs up by prompting people to wait until they are seriously ill before seeking care, said Anthony Wright, executive director of Health Access California, a patient advocacy organization based in Sacramento.
"It puts the incentives in the wrong places," Wright said. "It takes incentives away from ongoing and preventative care."
As benefits manager for Santa Monica-based American Golf Corp., Jeff Kuehn said he wanted to avoid taking another big bite out of employees' paychecks. At the same time, he didn't want high deductibles to discourage employees from getting preventive care.
As a result, the company, which manages golf courses across the country, will implement a health plan next year that requires a small co-payment for preventive care, such as checkups and vaccinations, but carries deductibles of up to $1,250 for more specialized services, such as nonroutine diagnostic tests.
"We want to keep people out of bankruptcy and encourage preventive care," Kuehn said. "We're hoping people will start going in and getting their annual exams. We hope they will go in and get their annual flu shots. We hope people will go in and take care of themselves. And we hope we will have a healthier population in the long run, and that will mean less costs for us."
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lisa.girion@latimes.com
