(11-03-2018, 12:28 PM)jj82284 Wrote:

(10-30-2018, 10:16 PM)mikesez Wrote: That's a legitimate complaint and I used to say things like that in these conversations.
It makes sense.  It is plausible.  But the evidence isn't there to say that this is our actual problem.
First, doctors do compete to see who will get on which plan and not all plans reimburse all doctors the same.  I would not call it patient centered, but if there is a doctor that patients prefer, they do get some leverage in the negotiations with insurers.  
Second, the cure to this problem is worse.  It has been demonstrated over and over that the high deductible plans cause people to wait too long to get treatment and needlessly risk their lives.  It's been demonstrated that they make us significantly less healthy without singificantly reducing overall health spending.

So I join us in condemning the ACA and it's syrocketting deductibles?

The ACA has very little to do with deductibles.
The bronze, silver, gold, grading is just about over all costs distributions and there are ways to achieve each grade with high and with low deductibles.
high-deductible plans were becoming a bigger part of the marketplace already. people are interested in high-deductible plan simply because the lower premium is the only premium they can afford.
The overall health system is just too expensive. Too many Middle Men.

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