Wednesday, February 3, 2010

When Less Is More and More Is More

Will people really take better care of themselves if they were forced to pay more out of pocket health expenses? That has been the knock against insurance policies that shield people from the actual cost of their health care. In an article published in the New England Journal of Medicine, researchers have refuted that notion.

In the research that looked at Medicare recipients, they studied the effects of increasing copays on patients and their well being. They discovered that patients who had higher copays wound up using fewer outpatient services, had more hospital admissions, and longer hospital stays. They conclude that patients refuse to pay more for their care therefore they bypass routine health maintenance and wind up being hospitalized more frequently.

So this raises a perplexing problem. Trying to lower the cost of health insurance by making everybody pay higher out of pocket expenses winds up costing more money in the long run with increased hospitalizations. But if you lower the cost of health insurance to, let's say free, you also make the system more expensive as more people will abuse the system.

I'm just a poor anesthesiologist. I have no idea how we are going to get ourselves out of this conundrum. If you have any brilliant insights, I hear they need a few in Washington.

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