Star Tribune reports on "perverse incentives" behind year-end rush to surgery

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Interesting story on consumer behavior with high-deductible health insurance plans – and how one surgeon said, “You could not design a less intelligent system.” Excerpt:

“People with insurance deductibles tend to put off medical care early in the year because they have to pay out of pocket. Some then burn through their deductibles anyway because of unexpected doctor visits or a trip to the emergency room. Anything else they get done this year is covered by insurance so they’re trying to cram in procedures before Jan. 1. …

Doctors report that deductibles do affect patient behavior. Many patients now ask about price. If in the past they demanded a costly MRI, now they’ll question whether they need one. The plans’ advocates say this sort of engagement is a first step to curbing the nation’s runaway health costs.

But once the deductible is met, “they go right back to their old behavior,” said Maureen Swan, a principal at health care consultancy MedTrend Inc. The incentive then is to use as many medical services as possible at little or no extra charge before the new year.”

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