Why policymakers should watch Switzerland’s high-deductible plans


As policymakers reflect on ways to potentially expand health coverage, a new study warns that high deductibles can still negatively impact people in countries with universal coverage.

Researchers at the University Hospitals of Geneva in Switzerland found that Swiss patients with high deductibles were more likely to forgo care than other patients, even in a system that offers universal coverage with good population health outcomes. .

The study followed 11,897 patients and found that those with high deductibles were more likely to skip care across all socioeconomic groups.

“We found that high-deductible plans were associated with an increased likelihood of forgoing insured health care,” the researchers wrote. “Similar results were seen in the United States, where enrollment in high-deductible health insurance plans was associated with decreased health care use.”

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The number of Americans enrolled in high-deductible plans has increased in recent years as employers seek ways to mitigate rising health care costs. However, this trend has been accompanied by a decline and employers are increasingly turning to alternative solutions to manage health care costs.

In 2016, around 40% of policyholders were registered with an HDHP, compared to 25.3% in 2010.

The researchers say that while the findings cannot be directly applied to the United States, the findings have implications for American stakeholders. If policymakers want to draw inspiration from Switzerland, they will have to take these potential inequalities into account, according to the study.

“Because policymakers may be inclined to adopt features of the Swiss health system, they should be increasingly aware of the potential inequalities of care associated with the design of the health system in addition to those linked to individual factors” , they wrote.


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