TY  - RPRT
        AU  - Ayyagari, Padmaja
AU  - Salm, Martin
AU  - Sargent, Eric
        TI  - Can a Deductible Kill? The Effect of Patient Cost-Sharing on Health
        PY  - 2026/Feb/
        PB  - Institute of Labor Economics (IZA)
        CY  - Bonn
        T2  - IZA Discussion Paper
        IS  - 18420
        UR  - https://www.iza.org/publications/dp18420
        AB  - We study how health insurance deductibles affect healthcare spending and health using a regression discontinuity design and administrative data from the Netherlands. Exploiting an annual deductible reset, we compare patients admitted to the emergency room just before and after January 1. Patients admitted after the reset face zero marginal prices for care and incur 14\% higher annual healthcare costs. Despite substantially higher utilization, we find no effect on mortality or other health outcomes across income and health-risk groups. These results suggest that modest deductibles reduce healthcare spending without adverse health consequences.
        KW  - patient cost-sharing
KW  - health insurance
KW  - mortality
KW  - regression discontinuity design
        ER  -