"My point is that it's not going to happen. All of the demand side solutions that are even remotely on the table are plans to increase demand, or perhaps to shift demand from one group to another. There isn't really anyone who's pressing for significant increases in deductibles as a solution."
I clarified I meant demand side and not supply. That said the ENTIRE purpose to the health savings account model is a reduction in utilization/demand and increased efficiency when utilized. This is not driven by increasing the deductible to save premium. It is a entirely separate buying decision.
Example: family premium on a PPO at $1100 per month with the possibility of spending another $8000 in out of pocket costs for the year. Family premium on the high ded. $650 with a deductible of $4800 but a max out of pocket of $5500 which is less than the out of pocket on the expensive PPO. You save $450 per month in premium which you dump in the savings account pre tax costing you $300 per month. Now you're sitting there having spent net $950 per month vs the original $1100 for a small savings. Now however you have $5400 in a savings acct and a max out of pocket of $5500....your bills are all paid with not even a single office visit charge to boot. Easy math. The trick then becomes going to the doctor means taking money out of your retirement savings acct to pay the bill or paying for it with after tax dollars. You wonder why I'm sitting here with a chest cold and not going to the doctor. The $150 I'd spend will be $1000 by retirement and I'm not that sick. This is just an example but the concept is purely to limit demand and improve efficiencies....this is not your dad's high deductible. Thank you GWB.
I don't know what's going on in other states but here in Fla., the governor finally put two and two together. They approved opening two more medical schools here in Fla. The first one opens in 2009. It's going to be a long time before the dividends arrive, obviously, and by then the problem will be much worse than it is now. But at least someone has figured out what the problem is, and has actually done something to try to address it.
Of course, even if they do produce more doctors in Fla., there is nothing to prevent them from moving out of state. So I am hoping that other states will follow suit and do the same instead of raiding our state to satisfy their doctor shortages.
The worse this problem gets, the more likely it is that Hillarycare or something like it is eventually going to be forced down our throats.