New EPI Report: Health Care Cost-Sharing Hurts Consumers
Cost-sharing, mistakenly embraced as a reform tool by some health care economists, will neither make care more affordable nor improve public health, says an
important new report
from the
Economic Policy Institute
(EPI).
The premise behind cost-sharing, sometimes described in layman's terms as making sure consumers have “skin in the game,” is simple: If people had to pay more out-of-pocket, they’d stop running up health costs with all that unnecessary care.
“That’s the premise, but it’s completely wrong,” explained Shaun O’Brien, assistant policy director for health care and retirement at the AFL-CIO .
First, a major driver of health care costs for consumers comes from care that's put off, not too much care, the report says.
Take, for example, a middle-aged man with hypertension. More “skin in the game”—in the form of more expensive checkups and blood pressure medication—might successfully deter him from a $250 doctor visit but could contribute to a $1 million trip to the emergency room for a heart attack (estimated by the National Business Group on Health ), and then he’ll still get that doctor’s visit and the blood pressure medication.
Second, the poorer a person is, the higher the burden of cost-sharing, said Elise Gould, who wrote the EPI report.
“That’s the real tragedy of the cost-sharing. It hurts vulnerable people the most,” Gould said.
To cap it all off, cost-sharing wouldn’t actually lower the overall price tag for health care in America, because it fails to address the forces that have relentlessly pushed up prices.
The power of health care reform to lower costs for consumers will come from more care—routine and preventive care—not less, the report explains. And the Affordable Care Act already addresses the pressure behind high and rising costs, by focusing accountability on the health care and health insurance industries.
Read more about the astronomical health care costs in the U.S. in Steven Brill's article: Bitter Pill: Why Medical Bills Are Killing Us - TIME
