Here is the crux of the matter; do you and do you believe other people spend more on health care simply because their out-of-pocket costs are minimal or none? Members of Congress and policy makers do.
Do you believe that engaging health care services will change measurably if the patient pays the Medicare 20% coinsurance?
For that to be true don’t you also have to believe that patients welcome, maybe seek unnecessary health care, that only because the may not be liable for a $10.00 co-pay they run to the doctor when otherwise they would not?
My employer-provided Medicare supplemental coverage has a $750 deductible and pays nothing of my coinsurance until total charges for the year reach $5,000. In other words, I must pay the first $1,750 each year. While I may not be typical, I can assure you that when my wife needed health care, none of that was a factor, going to the recommended, highly rated surgeon was.
There is no question that unnecessary health care is a problem, but is it patient driven or patient controlled?
Restrict Supplemental Coverage – $50 billion to $125 billion.
Medigap plans tend to be a bad deal for both beneficiaries and the federal government, resulting in higher Medicare spending and greater out-of-pocket costs for most seniors. Policymakers could reduce excess utilization by further limiting the ability of Medigap plans to provide first-dollar coverage. Doing so would reduce net out-of-pocket costs for Medicare beneficiaries because it would lower the high premiums they currently pay for Medigap plans. Policymakers could also apply this principle to employer-sponsored retiree health benefits by allowing employees to “cash out” of their employer-provided plan in exchange for a premium subsidy and restricting TRICARE-for-Life supplemental coverage from covering first-dollar costs as well.