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" ... For example, there’s a mandated number of types of services that are covered. It’s not just the copays and the deductibles, but also the essential benefits. The essential benefits. There’s the premium tax which gets passed down to consumers in the form of higher premiums. So there are a couple of things on the margins that maybe add another 10% to the increased priced, but the biggest ones are what you might say changes to the risk pool: covering everyone’s preexisting conditions and having the young subsidize the old. That’s the risk pool portion. ... "
" ... In spite of its new prevention emphasis, Medicare does not pay for routine hearing and vision screenings. Problems can be identified during a wellness visit, but not diagnosed, and no coverage exists for glasses or hearing aids. Adding coverage for these items would require careful thought about copays, deductibles and even means-testing, but addressing them head-on is a much more promising route to savings and keeping seniors well than unheeded advice. Correcting these problems would also greatly add to seniors’ overall quality of life. ... "
" ... Many insurers have been proactive in deploying excess funds: reducing copays, investing in telemedicine, and taking measures that address social determinants of health (SDOH), such as allowing nurse practitioners to prescribe medicines — particularly important in areas where physicians are in short supply. Some plans are also supporting hospitals directly. ... "
" ... Proponents of the Cadillac Tax argue that very generous health plans tend to have low or nonexistent employee responsibility for deductibles or copays. Without the prospect of paying a significant copay, employees won’t weigh the price, necessity and quality of services before they seek care — since it’s all “free,” anyway. That lack of consumer vigilance drives costs up even further, hence the need to impose a tax that ensures people have some incentive to police their use of health care services. ... "