Wonks Anonymous would like to be spared the unpleasant task of bursting balloons, but he has observed a recent increase in charity care provided by at least one hospital chain and a large medical group. Idle curiosity prompted him to investigate this phenomenon and he discovered that the increase was tied an increase in the sale of High Deductible, aka "Consumer Driven", health plans, by one of the insurers whose coverage the hospitals and medical group accepted.

These plans, as you may know from previous posts in this blog, require the insured to make substantial payments before insurance coverage goes into effect. A restaurant worker with $25,000 annual income might be covered by a policy that required a $5,000 deductible.

Wonks Anonymous would like to point out that the worker in question would probably not be able to raise this sort of money in the event of a medical emergency. Indeed, the worker might try avoid the ordinary $75 – $100 fees for a doctor visit when she was not feeling well – a circumstance which might even increase the probability of a medical emergency. When things got bad enough, the worker in question would go to the same place she has always gone: the ED. The providers who saw her would then be forced to either waste time and energy in fruitless efforts to collect the $5,000 deductible, or write it off as charity care.

It would seem that these High Deductible Health Plans bring us right back to where we started. But I guess that Health Insurers will be making a bit of profit on them – so it's all good.