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Holly Calvillo, right, with her husband, Joe, and their son Alex, regrets signing up for a high-deductible health plan through her employer.

Curbing health bills brings different cost

By CHEN MAY YEE, Star Tribune

Last update: June 10, 2009

Two years ago, Holly Calvillo signed up for a new type of health insurance that was just starting to get popular.

It had a nice low premium but a high deductible. Calvillo and her husband were young and healthy. She figured that with her employer's contributions to a health savings account, they would save money.

One unexpected pregnancy and C-section later, her medical bills came to $7,000. From then on, every family doctor visit was preceded by this question: "Can we afford it?"

Once, Calvillo suffered weeks with a bladder infection before calling the doctor. "I drank a lot of cranberry juice," said Calvillo, 29, of Minneapolis. "We were just trying to make it."

Five years after their introduction, high-deductible insurance policies linked to health savings accounts have delivered on their promise. People are thinking twice before seeing a doctor. They're asking about prices and shopping around. As a result, growth in medical spending in Minnesota has slowed dramatically and, in some cases, stalled.

But one important question remains unanswered: Are people cutting essential care as well as unnecessary treatment?

If so, the idea of harnessing consumer choice to reform American health care might backfire, pushing consumers into decisions that undermine their health and driving up costs in the long run.

Doctors say they see worrisome signs: patients skipping colonoscopies and other screenings, or not showing up for follow-ups. Because the policies are new, most of the evidence remains anecdotal.