Tony has a strong expertise in the healthcare and managed care/payer arena. He currently manages the workflow of Oncology Business Management, a business trade journal geared towards community oncologists/hematologists.

Americans Enrolled in High-Deductible Health Plans Concerned About Medical Expenses

Published: Wednesday, Oct 15, 2014

Most privately insured Americans between the ages of 18 and 64 are satisfied with their health care plans, but for those enrolled in high-deductible health plans (HDHPs), a different story emerges. This group expressed concerns about the uncertainty of major medical expenses and skipping necessary medical treatment because the cost of healthcare is a significant financial burden, according to results from an Associated Press-NORC Center for Public Affairs Research survey.

“The survey reveals that a sizable number of Americans who have private health care coverage are satisfied with their plans,” said Trevor Tompson, director of the AP-NORC Center. “But the fact that one in eight of them are finding their medical bills pose a major financial hardship is clearly a cause for concern.”

That amounts to more than 16 million people who face major financial hardships like going without food or using up all of their savings as a result of medical bills.

Howard L. (Jack) West, MD, of the Swedish Cancer Institute in Seattle, Washington said, "I'm concerned about CDHPs in terms of rapidly rising costs of chemotherapy agents, now often eclipsing $10,000 a month for agents that have no fixed endpoint. We could easily see $1 to $2 million lifetime caps for coverage exceeded for many cancer patients in that scenario.”

Potential delays in seeking medical attention is also a concern. In an ASCO Post article about the Affordable Care Act’s high-deductible plans, Martin J. Heslin, MD, MSHA, chief of surgical oncology and associate director for clinical programs at the University of Alabama at Birmingham Comprehensive Cancer Center said, “The concern is that patients might not seek care in a timely fashion or that they might be financially compromised with a very high deductible for lifesaving cancer care.”

The nationally representative survey, with funding from the Robert Wood Johnson Foundation, was conducted with 1,004 privately insured adults age 18 to 64. The survey includes 267 respondents who report being enrolled in an HDHP, a segment that includes about 36 percent of those with private insurance plans, a number that has more than doubled since 2007.

Other key findings from the survey include:
  • Significant numbers of privately insured individuals don’t go to the doctor when they are sick (19%), go without preventive and recommended care (18%), use up all or most of their savings (18%), and go without basic needs (13 percent).
  • Respondents report not being deterred from using their health care benefits because of cost and that the cost of health care does not have a large impact on their finances.
  • The privately insured who report having a HDHP are more likely than those who do not to decrease their contributions to savings (41% vs 26%) and retirement plans (28% vs 15%) as a result of health care costs.
  • Nearly 1 in 4 adults age 18 to 64 covered by a HDHP reports that paying for health care expenses caused them to use up their savings.

National Survey: Privately Insured in America: Opinions on Health Care Costs and Coverage. Available at
Piana R. Cancer Care Under the Affordable Care Act. The ASCO Post. Available at:,-2014/cancer-care-under-the-affordable-care-act.aspx

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