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Home E-Weekly January 24, 2017

Doc's High-Deductible Experiment an Eye-Opener

Published: January 23, 2017

DOUBLE STANDARD Ashish Jha, MD, MPH, ignored advice he says he'd give his patients.

High-deductible healthcare plans, one of the primary targets for critics of the Affordable Care Act, aren't likely to disappear in the near future, regardless of what plan the new administration puts forward. Tom Price, MD, appointed to head the Department of Health and Human Services under the new administration, says they "make a whole lot of sense for many individuals."

But what kind of impact do such "catastrophic" plans have on the healthcare choices people make? Ashish Jha, MD, MPH, a health policy professor at Harvard University, decided that firsthand experience might provide valuable insight. He enrolled his family in a plan with a $6,000 deductible.

As reported by Newsworks, Dr. Jha and his wife, Deb Stump, say the experiment led to some unexpected difficult decision-making, such as when their son needed a follow-up with a specialist after having surgery. Though their income is higher than most people with such plans, they hesitated before making the appointment, knowing it would be expensive. They eventually had a "probably 2-minute visit," he says, that cost $465.

But when Dr. Jha, who has a condition that occasionally makes his heart race, recently had a spell that lasted a half-hour or more, he decided not to go to the ER, knowing he'd likely be on the hook for $2,000 or more if he did. His racing heart eventually calmed down, but the incident was enlightening. Ms. Stump, he says, asked him what he would say if one of his patients had called him with the same symptoms. "And I said, ‘oh, yeah, that's easy. Go to the [emergency department].'"

Jim Burger

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