Isn’t patient cost-sharing a good way to control costs?

Background Information

Debate Question:This is what a short summary question would look like.

Many patients have insurance that includes deductibles (spending levels they must reach before their policy pays anything) and co-payments (fees for hospitals, doctor visits, drugs, lab tests, etc. that cover portions of the actual cost). Sometimes this cost-sharing is very high. The two main reasons for cost-sharing are that it 1) reduces insurance premiums and 2) is believed to make consumers think more about whether they really need a potential treatment.
in favor
against

Ensuring that patients have “skin in the game” makes them smarter consumers of healthcare.

Zetema PanelistZetema Panelist In Favor
  • +3 Good Point

It’s insulting to say that patients must have “skin in the game,” since it’s their personal health on the line and most patients already pay for a good deal of care out-of-pocket.

Zetema PanelistZetema Panelist Against
  • Good Point +1

Patient cost-sharing reduces the use of unneeded care, and there’s a lot of waste in the system. 

Zetema PanelistZetema Panelist In Favor
  • +2 Good Point

Cost-sharing is a blunt instrument. It does reduce the use of low-value care, but also of care that patients truly need. Thus it’s bad for health as well as for patient finances.

Zetema PanelistZetema Panelist Against
  • Good Point +1

Deductibles and co-payments make consumers smarter because they can see the cost of care. 

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Many studies have shown that while cost-sharing reduces demand for care, it doesn’t consistently cause patients to make better decisions. 

Zetema PanelistZetema Panelist Against
  • Good Point +1

Cost-sharing is necessary from an actuarial standpoint to make health coverage affordable. The alternative is higher premiums, which are unfair to people who rarely use the healthcare system. 

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

There are better ways to make the numbers work, including greater government or employer subsidies. And it’s not fair to penalize heavy healthcare utilizers just because they’re sick or get injured.

Zetema PanelistZetema Panelist Against
  • Good Point +1

Cost-sharing is a reasonable way to ensure that patients who benefit from the healthcare system pay their share.

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Healthcare delivery and payment are so complicated that there’s no consistent relationship between how much someone costs the system and what they pay. 

Zetema PanelistZetema Panelist Against
  • Good Point +1

High deductible plans make healthcare insurance more like other types of insurance, where users pay the smaller expenses themselves and only rely on insurance for large, unexpected expenses. 

Zetema PanelistZetema Panelist In Favor
  • +1 Good Point

Since only 5% of Americans account for 50% of healthcare costs, these Americans meet their deductibles early each year and then have little cost-sharing. Healthier Americans with high deductible plans wind up paying for everything they use, so they pay a lot in premiums but don’t get any payment from their insurance. 

Zetema PanelistZetema Panelist Against
  • Good Point +1

What do you think?

Isn’t patient cost-sharing a good way to control costs?

Isn’t patient cost-sharing a good way to control costs?

You've already completed this survey. Thank you for participating!