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High-deductible health insurance trims cost at expense of preventive measures, RAND study says. Posted: March 25th, 2011

By John Frook

In what is believed to be the largest study of its kind, RAND Corp.'s health policy research division found that consumers with high-deductible health insurance cut both necessary and unnecessary care.

The just-released study of more than 800,000 U.S. families showed that those who changed to high-deductible health insurance policies cut their health spending an average of 14 percent when compared to families in health plans with lower deductibles. Childhood immunizations, cancer screenings and routine diabetes tests were among preventive measures to go by the wayside, according to RAND.

A dangerous health insurance trade off

"Patients reduced preventive care, and if this persists, it is likely to have health consequences in the future," said RAND statistician Amelia M. Haviland in a press statement. "Cutbacks could cause a spike in health care costs down the road if people end up sicker and need more-intensive treatment."

For the purposes of the study, high-deductible insurance was defined as plans with deductibles greater than $1,000 per person. The study looked at families insured through one of 53 large employers offering high-deductible health insurance between 2004 and 2005.

High-deductible health plans gaining popularity

It is estimated that about 20 percent of Americans with employer-sponsored health insurance were enrolled in one of these "consumer directed" high-deductible health insurance plans by 2009, and 54 percent of large employers offered at least one of these plans to employees by 2010, RAND said.

"There's general agreement that the U.S. health care system needs to reduce costs while maintaining quality," Haviland said. "We found that at least in the short run, high-deductible health plans are providing the desired reduction in costs. But they are also discouraging families from getting the preventive care they need."