Why policymakers should be watching Switzerland's high-deductible plans

A clipboard with a paper reading "High-deductible health insurance plan"
A new study examines high-deductible plans in Switzerland. (designer491/Shutterstock)

As policymakers mull ways to potentially expand health coverage, a new study warns that high deductibles can still negatively impact people in countries with universal coverage.

Researchers at Geneva University Hospitals in Switzerland found that Swiss patients with high deductibles were more likely to forgo care than other patients, even within a system that offers universal coverage with good population health outcomes.

The study tracked 11,897 patients and found that those with high deductibles were more likely to skip care across all socioeconomic groups.

"We found that high-deductible plans were associated with an increased probability of forgoing insured health care," the researchers wrote. "Similar results have been observed in the US, where enrollment in high-deductible health insurance plans was associated with decreased health care utilization."

RELATED: AMA issues recommendations to ease challenges of high-deductible health plans

The number of Americans enrolled in high-deductible plans has been on the rise over the past several years as employers seek ways to mitigate rising healthcare costs. However, that trend has come with pushback, and employers are increasingly looking to other solutions to address healthcare spend.

In 2016, about 40% of the insured were enrolled in an HDHP, up from 25.3% in 2010.

The researchers say that while the results cannot be directly applied to the U.S., the findings do have implications for American stakeholders. If policymakers want to take a cue from Switzerland, they'll need to account for these potential inequities, according to the study.

"Because policymakers may be inclined to adopt features of the Swiss health care system, they should be increasingly aware of potential inequities in care associated with healthcare system design besides those related to individual factors," they wrote.