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Health Dog Bites Man

Does paying for even some medical care out of pocket reduce costs over time? Here is the latest:

using data from 13 million individuals in 54 large US firms to estimate the effects of a firm offering CDHPs on health care spending up to three years post offer.

We find that spending is reduced for those in firms offering CDHPs in all three years post. The reductions are driven by spending decreases in outpatient care and pharmaceuticals, with no evidence of increases in emergency department or inpatient care.

By the way, and this is a HUGE by the way, an error committed by nearly everyone in discussions of living standards, costs, etc. is that spending and costs are the same thing. This paper shows that spending fell, it says nothing about costs. 

One more observation: it is a little surprising the authors find positive results nonetheless. What we have done in introducing CDHP into the current “system” is simply lay them on top of a system that is utterly incapable of handling consumer questions and desires to know pricing at the user end, and nonetheless we still see spending reductions. The next time you go to a doctor ask them what something costs and enjoy the baffled look they give you or the gymnastic routine they perform when they start to utter, “it depends.”


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