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Making people pay more of their health care bill out of pocket does not make them smarter shoppers, according to a new study published in Health Affairs, which corroborates earlier research.

The big picture: Part of the idea behind those ever-increasing insurance deductibles is that patients who have to put more of their own money on the line will become better consumers, comparison-shopping for the highest-quality, lowest-cost services. But it doesn't seem to work that way in the real world.

What they're saying: In the Health Affairs survey of people with high-deductible plans …

  • Just 25% had talked to their provider about how much something would cost.
  • 14% had compared prices at multiple facilities.
  • 14% had compared quality metrics for multiple facilities.
  • 7% had tried to negotiate a price.

Between the lines: People don't do these things because they don't even think of it, or assume it won't work. Or, to borrow some truly glorious academic-speak: "Perceptions of futility were common impediments to engagement."

  • A separate study, also published in Health Affairs, did find one effect of high deductibles: They seem to make women more likely to delay treatment for breast cancer.

Yes, but: There's some evidence that if patients try to avail themselves of comparison-shopping tools, they can achieve real savings, at least for MRIs and other imaging procedures.

Go deeper

Cyber war scales up with new Microsoft hack

Illustration: Aïda Amer/Axios

Last week's revelation of a new cyberattack on thousands of small businesses and organizations, on top of last year's SolarWinds hack, shows we've entered a new era of mass-scale cyber war.

Why it matters: In a world that's dependent on interlocking digital systems, there's no escaping today's cyber conflicts. We're all potential victims even if we're not participants.

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Spaceflight contests and our future in orbit

Illustration: Aïda Amer/Axios

Wealthy private citizens are increasingly becoming the arbiters of who can go to space — and some of them want to bring the average person along for the ride.

Why it matters: Space is being opened up to people who wouldn't have had the prospect of flying there even five years ago, but these types of missions have far-reaching implications for who determines who gets to make use of space and for what.

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Axios-Ipsos poll: America looks for the exits after a year of COVID

Data: Axios/Ipsos poll; Chart: Danielle Alberti/Axios

A year after the coronavirus abruptly shut down much of the country, Americans are watching for a clear signal of when the pandemic will be over — and most won't be ready to ditch the masks and social distancing until they get it, according to the latest installment of the Axios/Ipsos Coronavirus Index.

The big picture: The poll found that more Americans are expecting the outbreak to be over sooner rather than later, as vaccinations ramp up throughout the country — but that very few are ready to end the precautions that have upended their lives.