Besides, since insurance organizations spend a large part of their expenses on calculation, maintenance, and reimbursement of small amounts claimed by insured persons, this method can reduce many of these additional administrative costs. In case of using deductibles, since the insured people are obliged to participate fully in paying their costs until they reach the deductibles amounts, more carefully and accurately they will use health care services, and potentially many unnecessary costs will be avoided. The reason for using this kind of cost-sharing was that insurers, physicians, and many other people believed that if insurers involve in paying for these costs from the very beginning of health costs, this would increase excessive use of medical services and consequently increases health care costs ( 5). The philosophy of deductibles is that most insured persons can afford low expenses of visits, medications, etc. In this method, the insured person must pay a certain and fixed amount for covered health care services before the insurance organization starts to pay ( 4). In response to this issue, insurance organizations have adopted different strategies to control unnecessary patients’ demands and increase resources for health care financing, most notably cost-sharing when receiving health care services in the forms of coinsurance, copayment, deductible, payment cap, and no-claims bonus ( 3).Īmong the above methods, one of the ways that have been taken into consideration in recent years in some of the world developed countries is paying deductibles. The most important of these impacts are reducing the welfare of people - especially the poor- due to non-optimal allocation of resources, increased premiums and reduced insurance coverage, negative external effects, reduced technical efficiency and allocative efficiency, as well as a reduction in using the benefits of risk pooling ( 2). Moral hazard has negative impacts on society and on the health care system. Moral hazard means changes in health-related behaviors and the amount of health care services consumed due to having health insurance ( 1). Meanwhile, one of the major issues that health care systems, and in particular the insurance organizations, have faced over the past decade, is the moral hazard issue. In facing increasing costs of health care systems around the world, limiting the costs is the common goal of most reforms conducted in health care systems. This issue is more eminent in health sector due to the application of diverse diagnostic, therapeutic and rehabilitation methods, as well as using advanced, expensive and complicated equipment for a significant proportion of the population. Today, due to advancement of technology in various fields of manufacturing and services, the growing costs have become inevitable.
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