Don people need “skin in the game” in order to control health care costs?
High deductible plans and co-pays can discourage people from seeking needed care. The Minnesota Health Plan controls costs through efficiencies not by erecting barriers to care. When people pay first dollar, they delay or avoid getting care and this ultimately leads to increased overall costs and worse outcomes. A recent study demonstrated that even a modest increase in co-payments (average increase $7.00) among elderly Medicare recipients led to a decrease in out-patient clinic visits but an increase in number and length of hospitalizations with an overall increase in cost. The study also concluded that increasing copayments may have adverse health consequences. The results were more pronounced for people with chronic medical conditions where deferring effective outpatient care is likely to have both adverse health consequences and lead to increased costs. Underuse is a bigger problem in this country- people self ration care because they can’t afford it and health problems get worse.
