Af­ford­able Care Act is epit­ome of a high-de­ductible health plan

Modern Healthcare - - COMMENT -

Re­gard­ing the Jan. 9 editorial “The high-de­ductible plan trap” (p. 24), the Af­ford­able Care Act is the epit­ome of a high-de­ductible health plan. Con­sid­er­ing that $6,500 in­di­vid­ual and $12,500 fam­ily de­ductibles for non­sub­si­dized ben­e­fi­cia­ries put rou­tine care out of reach for most.

The cur­rent health sav­ings ac­count in­di­vid­ual con­tri­bu­tion limit of $3,400 ($6,750 for fam­i­lies) is more than enough, in most cases, to pro­vide for a good mem­ber­ship medicine (di­rect pri­mary care or concierge) plan and still have enough left over for po­ten­tial pri­mary-care re­lated ex­penses, such as imag­ing, labs and pre­scrip­tions.

This is es­pe­cially true when most mem­ber­ship medicine plans of­fer sub­stan­tial dis­counts on the above ser­vices due to the fact that most an­cil­lary providers of­fer cash pric­ing, which is sig­nif­i­cantly lower than in­sur­ance­based pric­ing.

Com­bin­ing a mem­ber­ship medicine plan with an HSA, a high­d­e­ductible plan for cat­a­strophic care, and pric­ing and prod­uct trans­parency tools will re­sult in a sig­nif­i­cant im­prove­ment in ac­ces­si­bil­ity, cost and qual­ity of pri­mary care, and sub­se­quently re­duce down­stream cost.

John Cham­ber­lain Pri­mary Care Di­rect

Gulf Shores, Ala.

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