While there has been significant growth in patients’ direct payments, it is increasingly malformed. In 2015, deductibles comprised 47 percent of patients’ direct payments, versus only 23 percent in 2004. However, deductibles are the crudest and least effective way for patients to increase the share of health spending they control directly. Deductibles are determined by the calendar year. They are a characteristic of what I have described as the (very flawed) heliocentric doctrine of health insurance.
Read more at NCPA's Health Policy Blog.