How Much Can You Afford Out-of-Pocket?

A health plan takes money from you, extracts its profits, and then returns the rest to you to pay your bills. You're going to get a better plan for a lower price if you are willing to pay the little stuff yourself without ever letting the plan get hold of that money.

An ideal plan would have a deductible, then pay a percentage of care to a yearly maximum (so patients are aware of costs and act as the plan's representatives, controlling their own costs), then pay 100% after the yearly maximum is exceeded (so someone with a catastrophic illness isn't stuck paying 20% of $500,000).

I don't see too many plans like that - the problem in employer health plans is that the deductible and yearly maximum must be low enough to be reasonable for the lowest-paid employee, and then would not be any disincentive at all to high-paid executives.



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©2000 Eileen K. Carpenter, MD