title: Sticker Shock: The Experience of a Health Care Consumer.
abstract: With implementation of the Patient Protection and Affordable Care Act, more Americans are gaining insurance coverage but often have high deductibles and significant out-of-pocket cost sharing. Deductibles routinely exceed $1,000 and often approach $5,000. In this essay, I share our family's experience attempting to navigate urgent medical decisions in a high-deductible health plan. In accessing urgent care for our child's fracture, we unknowingly encountered a 10-fold variation for what should be routine, low-cost technology (ie, plain film x-ray). Though the financial consequences for our family were minimal, for many families with high-deductible plans the financial implications are enormous. Through this experience, I learned that the principles of consumer-directed health care-that patients can and should price shop for care-are flawed in urgent and emergent situations.
authors.affiliation: Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania dgrande@wharton.upenn.edu.
authors.forename: David
authors.initials: D
authors.lastname: Grande
mesh_terms: D003669:Deductibles and Coinsurance; D005102:Health Expenditures; D006801:Humans; D058991:Patient Protection and Affordable Care Act / Q000191:economics*; D010820:Physicians; D014481:United States