The Dreaded Deductible





A recent article in the NY Times discusses how consumers that actually have health insurance are foregoing medical care. With more and more health plans having a high deductible, we’re responsible for up to the first $6000 before the deductible is met and our insurance benefits kick in. Since consumers don’t want to pay so much out of pocket, they’re avoiding some tests until they feel it’s really necessary. I recently wrote about this phenomenon on this blog here.


The NY Times article, as expected, focused on the calamity that is the “high deductible” and how people choose to save money at the possible detriment to their health. While I’m not suggesting avoiding all recommended tests, a high deductible may make medical sense in addition to economic sense. Consider this.


From an economic standpoint, a high deductible is reasonable. If we don’t think we’ll be using our health insurance, ie we’re pretty healthy, paying less in monthly premiums with the unlikely possibility of paying more in the way of a deductible may cost us less in the long run. But it also makes sense from a medical perspective.


There are times when a doctor orders a test out of an abundance of caution. But just because you have a headache doesn’t mean you need an MRI to diagnose a brain tumor. Having a high deductible may encourage us to avoid unnecessary medical tests when we simply have a headache. Granted, the example in the NY Times article cites a woman that has an abnormal ballooning of a blood vessel in her brain (an aneurysm) that requires monitoring. Because her deductible is so high, she won’t be getting a brain scan this year to see if it’s grown. This is the exception.


In general, taking a moment to consider whether we need an expensive test at the first sign of a symptom like nausea, vomiting, or a headache, may introduce a little sanity into our healthcare decisions. We’re no longer living in the high flying days of getting whatever test we want or think we need because we just assume our insurance will cover it all.



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