Regarding the Jan. 9 editorial “The high-deductible plan trap” (p. 24), the Affordable Care Act is the epitome of a high-deductible health plan. Considering that $6,500 individual and $12,500 family deductibles for nonsubsidized beneficiaries put routine care out of reach for most.
The current health savings account individual contribution limit of $3,400 ($6,750 for families) is more than enough, in most cases, to provide for a good membership medicine (direct primary care or concierge) plan and still have enough left over for potential primary-care related expenses, such as imaging, labs and prescriptions.
This is especially true when most membership medicine plans offer substantial discounts on the above services due to the fact that most ancillary providers offer cash pricing, which is significantly lower than insurance-based pricing.
Combining a membership medicine plan with an HSA, a high-deductible plan for catastrophic care, and pricing and product transparency tools will result in a significant improvement in accessibility, cost and quality of primary care, and subsequently reduce downstream cost.