General Discussion

The costs are the costs - whether she "can" pay them or not. And the overall medical cost for the year is lower on a high deductible plan for people who actually have high medical costs.

Example:

Monthly premiums for $10,000 deductible plan, with a $10,000 out of pocket max: $150/month.

Monthly premiums for $250 deductible plan with a $10,000 out of pocket max, and a 20% copay. (simplified for purposes of illustration): $500/month

Assume her $200,000 are spread evenly over the year (again, for illustration purposes) - $16,667/month

High deductible plan: $10,000 +$150 for January; $150/month the rest of the year. Total cost for the year = $11,800.
Low deductible plan: $500 + $250 + $3283.4 for January; $500 + $3333.40 for February, $500 + $3133.20 for March then $500 for April-December. Total cost for the year - $16,000

I never said she could afford it. Simply that she has no choice - it is what it costs to keep her alive. Given that (most of the time) she wants to live, a high deductible plan saves her $4,200 a year, in this simplified analysis based on numbers close to the options she has had over the years.

Yes, the pain is greater for a single month versus being spread over 3 months. but then her health care is essentially free for the remainder of a year.

My point is that whoever did this analysis does not understand the economic impact of high medical costs - or has never done the calculations to compare the overall costs of the two types of plans.