Coronavirus Highlights the Pitfalls of Health Deductibles – The New York Times

That was one of the main reasons that, as part of the Affordable Care Act, all screening with an A or B rating from the United States Preventive Services Task Force would be free without cost sharing. When its deemed necessary for everyone, all barriers are removed.

In many other facets of necessary care, though, the U.S. system isnt nearly as thoughtful. When people have asthma, for instance, and theyre told they need a preventive steroid inhaler, that care is not optional. Doctors are not looking to have anyone question whether its worth their money versus an insurance companys money. We want them to get and use the inhaler.

The same holds true for many chronic conditions. People with high blood pressure must take their medication likewise, people with sickle cell disease, ulcerative colitis and, of course, cancer. When cost sharing is imposed for these diseases, the evidence suggests it leads fewer patients to take their drugs, which leads to worse outcomes.

In no disease is this clearer and more prevalent than diabetes. People with insulin-dependent diabetes, especially Type 1 diabetes, must take their medication, often many times a day, or they risk serious complications or even death in a very short period.

This is where the second reason to use cost-sharing comes into play. Perhaps there are cost-effective options for insulin. In that case, making sure one of them is available for low or no cost seems a good idea.

As things are set up now, when we look for care, there are usually almost no options available with low or no cost sharing. Everything costs money out of pocket, no matter what insulin you choose.

Alternatively, the system could recognize that some diseases or conditions need more care, not less. For these cases, cost sharing could be eliminated or significantly reduced.

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Coronavirus Highlights the Pitfalls of Health Deductibles - The New York Times