美国国家公共电台 NPR Employees Start To Feel The Squeeze Of High-Deductible Health Plans（在线收听）

RACHEL MARTIN, HOST:

One of the ways that companies keep their workers happy and healthy is to offer health insurance. Not everyone who gets coverage through their job, though, is so happy or healthy for that matter. Deductibles have skyrocketed over the last decade. Reporter Noam Levey covers health care for the Los Angeles Times, and through his reporting he found that people with jobs - people with health insurance through those jobs - are struggling to pay their medical bills. I asked him to explain what's going on.

NOAM LEVEY: I mean, we've spent so much time fighting about Obamacare over the last 10 years and talking about the uninsured that I think we lost sight of this quiet revolution that's happened with health coverage for the tens of millions of Americans who have coverage through an employer. These are the people who've seen deductibles rise astronomically - rising four times in the last dozen years - from about $350 on average to $1,350 on average.

In some cases, people are seeing 4,000, 5,000, even $6,000 deductibles that they have to pay out of their own pocket before their health insurance kicks in. Needless to say, many, many Americans can't afford those kinds of bills.

MARTIN: You talked with a lot of people who are living this right now. What did you hear?

LEVEY: Well, we heard some really heartbreaking stories. So we did a nationwide poll as part of this project. One of the things that we found was that half of Americans who get job-based coverage say they, or an immediate family member, in the last year have put off going to the doctor, not filled the prescription or delayed some other kind of medical care because of concern about cost.

We found 1 in 5 had depleted their savings to pay a medical bill in the last year. And 1 in 6 reported that they have had to make some kind of difficult sacrifice in order to pay a medical bill.

And I think those sacrifices are really - some of them were really, really gut wrenching. We talked to a 27-year-old chef in Western Virginia trying to start a family with his young wife. Wife had a miscarriage. They got such huge medical bills, he had to take two extra jobs and was working from 5:00 a.m. until 11:00 p.m. some days.

MARTIN: And these are people with health insurance.

LEVEY: These are people with health insurance. And this used to be something we heard about all the time for people who didn't have health insurance. But in many cases, these are middle-class people making 75, a hundred thousand dollars a year. But if they get a five or $6,000 medical bill, a family of four, kids in school - it's hard for a lot of people to come up with that kind of money.

MARTIN: You're not done, right? You're going to keep reporting on this subject. What questions do you still want to answer?

LEVEY: We're going to be looking at how these high deductible plans are exacerbating inequality at a time when this is a major issue for Americans about who's getting the gains in our economy. These health insurance plans, they're a fine deal if you're making enough money to put away several thousand dollars a year and you can cover your medical bills. But if you're living paycheck to paycheck and you get sick, it's really tough on those group of people.

MARTIN: Noam Levey. He is a national health care reporter with the Los Angeles Times. Thanks so much for talking with us about your reporting.

LEVEY: Thank you.