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

Go deeper

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Rural America has its own coronavirus problem

It's often easier to socially distance in rural America, but it can simultaneously be more challenging to get medical care.

Axios Re:Cap digs into the pandemic's urban-rural divide with microbiologist Amber Schmidtke, who has found that coronavirus-related morbidity is higher in many of Georgia's rural counties than in Atlanta.

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Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3:30 p.m. ET: 12,373,722 — Total deaths: 556,863 — Total recoveries — 6,794,982Map.
  2. U.S.: Total confirmed cases as of 3:30 p.m. ET: 3,156,234 — Total deaths: 133,746 — Total recoveries: 969,111 — Total tested: 38,032,966Map.
  3. Public health: The U.S.'s new default strategy: herd immunity — 23 states and D.C. are mandating face coverings.
  4. ✈️ Travel: Delta CEO says Trump administration should issue mask mandate for air travelAirlines say air quality, cleanliness lower risk.

Biden and Trump point fingers over "buy American" proposals

Joe Biden at a campaign event in Wilmington, DE. Photo: Alex Wong/Getty Images

President Trump and Joe Biden are going back and forth over the former vice president's "buy American" economic proposal, which Trump claims Biden "plagiarized" from him.

Why it matters: Biden is directly challenging Trump and his "America First" agenda with the release of his latest plan, focused on economic recovery and re-investing in American manufacturing in the wake of the coronavirus pandemic.