As this New York Times opinion piece notes, cost-sharing (e.g. co-payments and deductibles) is used to decrease health spending. Cost-sharing may be effective in prompting people to think twice before seeking medical care or when selecting among options, but is it helping us reach the end goal of reducing the overall spend in the long run?
Treatment rates for childhood asthma are a particularly useful indicator, as having asthma inherently requires medical care, and preventive care is more effective and cost-efficient than treating someone during an attack. In other words, having to pay a large co-pay or deductible may discourage necessary treatment which only prolongs problems and makes them more expensive and more difficult to treat. A study just released in JAMA (Journal of the American Medical Association) Pediatrics indicates that poor families who have private insurance with higher cost-sharing are more likely to skip recommended care than those with lower cost-sharing or Medicaid. As the piece opinions:
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.