Sep 27, 2019 - Health

The "skin in the game" theory of health care hasn't panned out

Caitlin Owens

A hospital sign with the 'H' replaced with a dollar sign — Illustration: Lazaro Gamio/Axios

The theory that putting patients on the hook for more of their health care costs would make them better consumers — thus driving down overall costs — hasn't panned out, the LA Times' Noam Levey writes in his latest piece in a series on deductibles.

Why it matters: Health care prices are still rising, and are largely untethered to quality. At the same time, care has become increasingly unaffordable for many Americans.

This, in turn, has driven today's political debates over drug prices, surprise medical bills and overall costs.

Between the lines: High deductibles hasn't led to the kind of shopping that would be necessary for the "skin in the game" theory to be successful.

That's because shopping is often impossible, either because the service isn't planned in advance or because providers and insurers don't always make prices available ahead of time.

What they're saying: "We overestimated the ability of consumers to be good stewards of their healthcare dollars in a system that is very unfriendly to consumers, and underestimated the support they would need from us," Marcus Thygeson, a former Blue Shield of California executive who worked on early efforts to develop "consumer-directed health plans," told the LAT.

My thought bubble: We've pointed it out before, but there's a strong irony to the fact that conservatives' darling policy idea has led to Americans being more willing than ever before to accept a single-payer health plan.

Go deeper: "Skin in the game" doesn't work

Add Axios on Google

The "skin in the game" theory of health care hasn't panned out

What to read next