Plans to cut health care costs may be backfiring

Study shows delays in breast cancer testing, treatment due to high deductibles could kill

Delay might be deadly.

Especially when it comes to women getting tested for breast cancer.

Many, however, nevertheless delay their testing and treatment when faced with high deductibles, according to a story by Reed Abelson this week in The New York Times.

High deductible plans, his story, says, "have become commonplace, a deterrent used by [insurance] companies to lower health care costs by discouraging unnecessary tests or treatments."

But those plans inherently carry great risks, Abelson writes, despite their having become much more popular "since the Great Recession 10 years ago [when] people increasingly deferred medical care, putting off elective surgeries and doctors' visits," action that did result in national health care spending slowing.

However, a recent study of women with insurance plans that carried deductibles of at least $1,000, the writer notes, "underscores the danger to consumers required to shoulder a greater share of those costs."

The study also professes that "women who had just learned they had breast cancer were more likely to delay." 

About half of all covered U.S. workers "are now enrolled in plans with a deductible of at least $1,000, and many must pay several thousand dollars in medical bills before their plans even start to cover their care," Abelson contends.

Moreover, a survey of employer benefits by the Kaiser Family Foundations shows "about 11 percent of covered workers have a deductible of at least $3,000" and, the Times story maintains, employers are "more frequently giving their workers no other option."

A review of medical claims, Abelson's article charges, "exposed a pattern: Women confronting such immediate expenses put off getting diagnostic imaging and biopsies, postponing treatment."

Dr. J. Frank Wharam

The piece also quotes Dr. J. Frank Wharam, Harvard researcher and one of the study's authors, to the effect that those women "delayed beginning chemotherapy by an average of seven months."

The bottom line: "Slight delays added up to long delays," Wharam notes in the Journal of Clinical Oncology.

Survival rates are, naturally, higher for patients with some cancers if they're treated early.

In that regard, the Times piece goes on to report that "high-deductible plans pose a problem, say researchers who have studied them, because patients do not always distinguish between the care they should get and what they can do without."

The story also quotes Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center as it makes a key point: While high-deductible plans are meant to encourage people to think twice about whether a test or treatment is necessary and if it can be done at a lower price, "it's also frankly to impede their use of these services."

Although the plans apparently are succeeding in reducing the use of care, he asks: "The question is, at what cost?"

More insight into how the medical industry deals with the cost of care can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.