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Paul D. Jacobs and Gary Claxton
Comparing The Assets Of Uninsured Households To Cost Sharing Under High-Deductible Health Plans
Health Affairs, May/June 2008; 27(3): w214-w221. [Abstract] [Full Text] [Figures Only] [PDF] [Online Appendices][Erratum] [Reprints & Permissions]

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[Read Comment] Low-Income People Need Subsidies, Regardless
Greg Scandlen   ( 21 April 2008 )

Low-Income People Need Subsidies, Regardless 21 April 2008
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Greg Scandlen,
Founder
Consumers for Health Care Choices

Send comment to journal:
Re: Low-Income People Need Subsidies, Regardless

greg{at}chcchoices.org Greg Scandlen

Paul Jacobs and Gary Claxton discover, unsurprisingly, that it would be hard for low-income people to pay for their out-of-pocket maximums out of current liquid assets in a "consumer driven" health program. Therefore, they contend, these programs are not a good solution for the uninsured.

They neglect to explain how people who can’t afford these deductibles and coinsurance provisions will be able to afford the premiums to such avoid cost sharing. This is not rocket science, folks. Low deductibles = high premiums. High deductibles = low premiums. Take your pick. Poor people will have to be subsidized in either case. But with a high-premium policy, every penny is lost to the insurance company forever. With a high-deductible policy, the consumer has an opportunity to save money for future needs. Plus, cash payment at the time of services is far more efficient than processing the same bills through an insurance mechanism. So, people will be able to get more bang for their health care buck with a consumer-driven program. Not an unimportant consideration if we are asking taxpayers to subsidize the coverage.

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