By “access” I don’t just mean ability to find it, I mean ability to afford it. So here is an example. Old insurance: You and your employer split the premiums to the tune of, say, $600 a month, you paid co-pays of, let’s say, $15 for an office visit and $50 for an emergency room visit. So if you went and got a physical, plus one more visit, that was $30 and let’s say one visit to the emergency room, for which you paid $50 but when you got the bill you learned that without insurance you would have paid $7000. So without the insurance you would have paid, let’s say, $200 for the physical, $120 for the other visit, and $7000 for the ER visit for a total of $7320.
Under the new plan you and your employer split $300/month and you have a yearly deductible o $13,000. When you go get your physical it turns out to cost $648 with all the lab fees and things, and when you go to the ER it costs $7000 again, along with lab fees and diagnostic stuff, say $7400, and you get a bill from the hospital that says your insurance negotiated it down to $3000 and it’s due now. For a lot of people this is a large hunk of money, it’s all out-of-pocket, and its due now–plus, of course, you still have the monthly insurance cost.
So yeah, over the course of the year you are not actually paying any more. And you can probably call the hospital and negotiate a payment plan. But it still looks like a lot more money, and so…the next year you skip the physical, and you decide the bad cut isn’t really bad enough to go to the emergency room, you can probably put on some hydrogen peroxide and band-aids. And so on.
Voila, less access.
$7000 over the course of a year, deducted from your paycheck before you even see it vs. $3000 due right now is really going to affect your perception of what you’re paying for health care. Or to put it another way, now you really know what your health care costs and it’s too much. Even if, on a certain level, you know that the acetominophen you got at the ER, $28 for two pills, doesn’t reflect just the cost of the pill itself but cost of the training and expertise of the people who decided you needed it and administered it, and the overhead to keep the ER open and staffed, you also know that you can go to walgreens and get these pills and administer them yourself for about $6.