Women penalized by high deductible (”Consumer Directed”) health plans
[ArnieCare and MittCare are high-deductible plans.]
For Immediate Release
High Deductible Plans Penalize Women, Middle-Aged Adults, Sick Children Harvard Study Finds
A study by Harvard Medical School researchers finds that the
increasingly popular high deductible health plans are discriminatory
against women, leaving them with far higher out-of-pocket health
bills than men. The researchers also found that adults 45-64, those
with any chronic condition (such as asthma or high blood pressure)
and children taking even one medication were likely to suffer
financially in high deductible plans. The study, appearing in the
April 2007 issue of the Journal of General Internal Medicine,
analyzed nationwide health spending data from the Medical Expenditure
Panel Survey. The researchers calculated the median annual medical
costs of men, women, various age groups, and of people with a variety
of medical conditions. (Half of people spend more than the median and
half spend less).
Under high deductible health plans (which are also called “consumer
directed health plans”), patients are responsible for at least $1,050
(often $5000) in medical bills before insurance kicks in. High
deductible plans are a cornerstone of the new Massachusetts’ health
reform; most of the newly-mandated, unsubsidized plans have
deductibles of $2000, with co-payments and coinsurance after that.
Such plans carry lower premiums than traditional coverage. Employers
and politicians have touted high-deductible plans as a cost-saving
strategy, hoping that they will make patients more cost conscious
when they seek care. It has previously been recognized that young and
healthy individuals stand to gain under high deductible policies,
because few of them incur the high out-of-pocket costs.
The Harvard study is the first to show that most women will be
financial losers under high deductible plans. In 2006, the median
health costs for women age 18-64 was about $1000 higher than for men
($1,844 vs. $847). The difference was particularly striking among
young adults (18-44), with median expenditures for women being nearly
threefold higher than for men ($1,266 vs. $463). As expected, middle-
aged adults had far higher expenses than did the young, making most
of them financial losers in high deductible plans. For those aged
45-64, the median expenditure was $1,849 for men and $2,871 for women.
The researchers also found that most individuals with even mild
chronic conditions were likely to suffer financially in high
deductible plans. For the 26.9 million Americans with high blood
pressure, median expenditure was $3,161. The median for the 9.7
million receiving any treatment for arthritis was $5,425, while the
figure for the 5.2 million diabetics (on any medication) was $5,774.
Strikingly, the 12.1 million children who took even a single
prescription medication had median expenditures of $1,305.
Dr. Steffie Woolhandler, Associate Professor of Medicine at Harvard
and lead author of the study commented: “High deductible plans punish
women for having breasts and uteruses. Our costs are higher than
men’s because we need Pap tests, cervical cancer vaccine, mammograms
and birth control, and because pregnancy is expensive. When employers
raise deductibles, they’re giving women a pay cut. And when
politicians offer tax breaks for high deductible plans, they’re
discriminating against women.”
“High deductible health insurance penalizes anyone who’s sick. Even
common, mild problems like arthritis and high blood pressure make you
a loser in a high deductible plan. And these financial penalties keep
people from getting the routine care they need to prevent disastrous
illness later on”, said Dr. David U. Himmelstein, study co-author and
a Harvard Medical School Associate Professor. “High deductible plans
are mean spirited and unfair, and they won’t save our failing health
system. We need to care for everyone and spread the costs over men
and women, young and old, healthy and sick. We need better coverage,
not the ever-skimpier plans that politicians are pushing. In short,
we need national health insurance with first dollar coverage for all
Americans.”