Cost-Sharing Should Be a Scalpel. We’re Using it Like a Club.
ICYMI: NYT's The Upshot: Cost-Sharing Should Be a Scalpel. We’re Using it Like a Club.
05.23.14 | By Robert Zirkelbach
The New York Times’ The Upshot recently ran a piece by Aaron Carrol, “People With Chronic Illness Fare Worse Under Cost-Sharing,” looking at the impact cost-sharing has on consumers. Here are a few highlights from the article:
- “A study just published in JAMA Pediatrics looked at how children with asthma obtained care under different levels of cost-sharing, and how much stress their families were under financially because of their child’s illness. It’s important to understand that children with asthma, by definition, require care.”
- “What we see from this study is that families with higher levels of cost-sharing were significantly more likely to delay or avoid going to the office or emergency room for their child’s asthma.”
- “This isn’t a good outcome. We’re talking about children with a completely manageable chronic condition who are being hampered by cost-sharing. That’s not what cost-sharing is supposed to do.”
- “The difference between avoiding care and obtaining it wasn’t due to being insured or uninsured. It wasn’t due to having government or private insurance. It was due to cost-sharing. And cost-sharing is highest among privately covered individuals at the lower end of the socio-economic spectrum.”
- “A different, but complementary, study was published in The New England Journal of Medicine in 2010.”
- “Plans that increased co-pays saw two additional hospitalizations and 13 more days in the hospital per 100 people. These increases were worse in older people who lived in low-income areas, and among those who were documented to have high blood pressure, diabetes or a history of heart attack.”
- “Cost-sharing is bad for those who need care the most.”
- “In the United States, we have adopted a system where those who use the most care pay the most out of pocket. That may seem ‘fair’ in some way, but cost-sharing isn’t about fairness. It’s about reducing health care spending without negatively affecting health outcomes. It should be a scalpel. We’re using it like a club.”
Click here to read the entire article.