Chronically ill patients, who are more likely to require necessary care, should pay less for health insurance, Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine, argued in an op-ed for the New York Times.
The U.S. healthcare system should not apply cost sharing to all insurance beneficiaries equally, said Carroll, who pointed to a recent JAMA Pediatrics study that found high cost sharing led children with a manageable chronic condition (asthma) to delay or even skip recommended care.
"We want them to use the healthcare system. With respect to asthma, prevention and maintenance are far better than trying to treat a child already suffering from an attack," he wrote.
While it may seem fair that under the U.S. system those who use the most care pay more out-of-pocket costs, Carroll argued that such an approach to cost sharing won't reduce healthcare spending without hurting health outcomes. He cited the systems that France and Singapore follow as better cost-sharing examples. The former sets copays by sickness levels while the latter makes exceptions for chronically ill patients.
Moreover, a previous study found chronically ill patients who use high-deductible health plans (HDHPs) are more likely to go without care due to high costs, leading to a greater aggregation of costs. But if insurers incorporate secondary prevention of chronic diseases into the overall definition of prevention for HDHPs, they can better aid patients with chronic conditions while also reducing costs, according to a new report from the University of Michigan Center for Value-Based Insurance Design and Harvard University Medical School.
Despite the increased focus on improving health and reducing costs for consumers with chronic conditions, chronically ill patients represent a major opportunity to sell more long-term care coverage, Insurance News Net reported. As the nation gets older and lives longer, the cost of treating chronic conditions will surpass cancer treatments, increasing the need for healthcare coverage.