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Expand chart
Adapted from Ezra Golberstein using NHEA data; Chart: Axios Visuals

The health care services that rack up the highest out-of-pocket costs for patients aren't the same ones that cost the most to the health care system overall.

Why it matters: Americans likely have a distorted view of what is costing them the most, which affects where consumers direct their ire after receiving expensive medical bills.

What they're saying: "What you pay for health care is often more influenced by your health insurance than the actual cost of the service," Avalere's Chris Sloan said.

  • "It's hard to have consumer-driven market forces that impact costs if the consumer doesn’t understand how much any service costs and subsequently can’t 'shop around' or negotiate it down," Sloan added.
  • It also means that certain issues, like prescription drug spending, become politically elevated over other areas with lower cost-sharing.

Yes, but: Insurance was designed in part to shield patients from high health care bills, which typically are largest when a patient goes to the hospital. But most people don't go to the hospital in any given year.

  • And cost-sharing was designed to encourage enrollees from inappropriately using health care, even though it's become a way of off-loading costs onto patients.
  • "Most people are not itching to get admitted to the hospital, so it doesn’t make sense for insurance plans to discourage it through cost-sharing," said the Kaiser Family Foundation's Larry Levitt.

The bottom line: The health care costs that are hitting patients' pocketbooks hardest aren't the same ones that are driving health care spending through the roof, meaning that political action to address costs may be somewhat divorced from our long-term problems.

Go deeper

Updated 4 hours ago - World

U.S. airstrike kills senior al-Qaeda leader in Syria, DOD says

A displacement camp near the village of Qah in Syria's northwestern Idlib province. Photo: Ahmad Al-Atrash/AFP via Getty Images

A U.S. airstrike in northwest Syria on Friday killed senior al-Qaeda leader Abdul Hamid al-Matar, U.S. Central Command said in a statement.

Why it matters: Syria serves as a "safe haven" for the extremist group to plan external operations, according to U.S. Army Maj. John Rigsbee.

Updated 10 hours ago - Politics & Policy

Giuliani associate Lev Parnas convicted of campaign finance crimes

Lev Parnas, a former associate of then-President Donald Trump’s personal lawyer Rudy Giuliani. Photo: Stefani Reynolds/Bloomberg via Getty Images

Florida businessman Lev Parnas was convicted Friday on charges of conspiracy to make foreign contributions to political campaigns, according to multiple outlets.

Why it matters: Prosecutors said Parnas, then an associate of former President Donald Trump's personal lawyer Rudy Giuliani, funneled over $150,000 from a Russian businessman into U.S. campaigns as part of an effort to land licenses in the U.S.'s legal cannabis industry.

Supreme Court agrees to hear challenges to Texas abortion law

Photo: Saul Loeb/AFP via Getty Images

The Supreme Court on Friday agreed to hear two cases challenging Texas' abortion law, which bans the procedure as soon as six weeks into pregnancy, but left the law in place in the meantime.

Why it matters: The court is moving extraordinarily fast on the Texas cases, compressing into just a few days a process that normally takes months. And that schedule means the court will take up Texas' ban a month before it hears another major abortion case — a challenge to Mississippi's own 2018 ban on abortions after 15 weeks.