The average deductible for employer-sponsored high-deductible plans was $1,923 for single policies and $3,883 for family policies in 2007, according to the Kaiser Family Foundation and the Health Research & Educational Trust.
Under such plans, people pay out of pocket for routine or minor medical care. Insurance reimbursement only applies when they meet deductibles of several thousand dollars. That means patients will be less likely to go to the doctor even if they have chronic conditions that need to be tracked, Krauss said.
"It will undoubtedly lead to delays in diagnoses for diabetes, hypertension, glaucoma," he said. "That's the natural consequence of people not taking care of themselves."
Co-pays have also increased in recent years, from an average of $15 in 2002 to $19 in 2005, according to the Agency for Healthcare Research and Quality.
That may bar people from getting cost-effective care, said Ashley B. Coffield, a senior fellow at the Partnership for Prevention, a Washington-based organization that promotes preventive health.
A co-pay of as little as $10 can prevent a woman from getting a mammogram, according to a study published last year in the New England Journal of Medicine. Many other studies have shown that prescription drug co-pay increases of as little as $5 can dissuade older patients from filling prescriptions.
Johnston encouraged people to view their health like they do any valuable possession and consider a visit to the doctor, even if they have to pay out of pocket.
"I say to patients, 'If the transmission fails in your car, you would put out money to fix that,' " he said. " 'Your heart, kidneys and brain are more valuable than your car.' "
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shari.roan@latimes.com
