What a terrific piece of reporting Marketplace health beat reporter Dan Gorenstein turned in on the show last night!
It followed a comment from the likely new secretary of Health and Human Services at his confirmation hearings yesterday.
Tom Price said high-deductible catastrophic health plans make sense for a lot of people. And maybe they do, although how they work isn’t often explained.
Gorenstein explained it last evening from the perspective of whether it makes health care better for people. He did so through the story of Dr. Ashish Jha, a physician and Harvard professor who could apparently afford to try to insure his family with such a plan just for the academic exercise.
“I thought…it would be really useful, as a family, to know what it actually feels like to have to pay for everything out of pocket at least until you hit your deductible,” said Jha.
His plan, like most high-deductible plans, requires the policyholder to pay for everything until a certain amount — in his case: $6,000 — is reached.
One night, he might have been having a heart attack, Gorenstein reports. And he wouldn’t go to the hospital. Keep in mind: This guy’s a doctor.
These episodes usually pass quickly. But the most recent one, which Jha experienced after a bruising international business trip, was a particularly bad bout. At half-an-hour, his heart was still racing. After an hour, his wife urged Jha to go to the Emergency Room.
“And I was resisting it. She actually asked me, ‘if a patient of yours called you with this, what would you recommend to them?’ And I said, ‘oh, yeah, that’s easy. Go to the [Emergency Department],'” Jha said.
Though he knew he could be experiencing a heart attack, Jha didn’t want to spend $2,000 or more getting checked out in the ER — even though he said he could afford that. In retrospect, Jha said he should have gone to the hospital.
“But, you know, I knew there was a big bill waiting for me if I did, and I rolled the dice,” he said.
Jha got lucky. After an hour his heart rate began to slow.
But his experiment, putting his family on a high-deductible plan, is helping him see the reality of what many health care researchers are finding: these plans can put people in difficult positions. Sometimes, in fact, they can force people to make decisions as if they were their own doctor; and that’s something even a physician struggled to do for himself.
It was a brilliant piece of reporting to explain an important concept of health insurance alternatives.
Related: How To Create A Workable Republican Health Care System (Forbes)