Wednesday, July 22, 2009

How much out of pocket should a patient pay?

I'm concerned about the amount of out of pocket costs patients might be required to pay under the new plan to come. Currently the basic plan on the HIE under HR3200 calls for $5,000 out of pocket for a person, and $10,000 for a family. This seems so high to me!

Here is what the Commonwealth Fund says about subscribers currently:

"People enrolled in an individual market plan spend far more out-of-pocket and on premiums than those with employer-based coverage: the average family covered by an employer plan spends $2,250 out-of-pocket on health expenses, while those with individual insurance spend an average of $6,750. Adults with individual market coverage are also more likely to have high deductibles and face limits on what their plans will pay. More than two of five adults with coverage through the individual market report not getting needed health care because of the cost."

But, one of the main objectives of the HIE is to make insurance available to individuals on the same basis as those with group insurance. So, has that been achieved by HR 3200? Not in this respect, it would seem. Where did they get this, I have to wonder? If you need to save money, this doesn't seem to me to be the place to save it. It's like being defeated by your own hand.

Budd Shenkin

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