The latest Kaiser Family Foundation survey of employer health benefits concludes that “workers are shouldering higher health care costs as more employers demand bigger out-of-pocket payments from employees before their insurance kicks in.”

According to the survey of 1,927 employers, “annual deductibles — the amount employees pay out of their own pockets for medical care before their insurance coverage starts — jumped an average of 29%, to $1,344, for those with family coverage.” “This is partly, but not entirely, driven by growth in consumer-directed plans such as those that qualify for a tax-preferred Health Savings Account,” the study concludes.

Consumer driven health care plans do increase out-of-pocket expenses. “We may be seeing the tip of the iceberg toward less comprehensive, skimpier coverage,” Kaiser President Drew Altman warned.

But under Sen. John McCain’s (R-AZ) proposed health plan, too many Americans may actually hit the iceberg. As a recent study published in Health Affairs points out, McCain’s plan would push more Americans into the unregulated individual health market place. But, since “it is much more expensive to sell insurance to millions of individuals,” a family that moves from the group to the individual market will experience higher costs:

The typical deductible in nongroup plans is about $2,750, compared to about $1,000 for group policies. Coinsurance rates average 26 percent in nongroup plans, compared to 20 percent in a typical employer-based plan. For plans with copayments, the average copayment in the nongroup market is between $30 and $40 per doctor visit, well above that of group plans. Many services are not covered at all. Thus, much of the apparent savings from shifting to nongroup coverage would be offset by higher out-of-pocket costs for care.

Medical professions are saying “thanks, but no thanks” to the Bush administration’s proposed regulations allowing health care workers to opt-out of providing abortion and contraceptive services.

Health and Human Services Secretary Michael Leavitt has argued that the new rule is necessary to protect the “freedom of expression and action” of medical professionals, but medical professionals disagree. The American Psychiatric Association and the American Academy of Pediatrics say that “doctors and nurses are already not required to perform abortions or sterilizations.”

Indeed, the proposed regulation would be redundant if it weren’t so expansive. By using an “opinion put forth several months ago by the American College of Obstetricians and Gynecologists” as pretext to issue new regulations, Leavitt is potentially expanding the existing conscience exemption. Medical professionals have expressed concern about the consequences of the new rule:

Implementation of this regulation would effectively allow health care providers’ personal beliefs to override patients’ right to full disclosure of accurate information and available health care resources.

Similarly, in a separate letter to the HHS, 13 attorneys general argued that “the rule was too vague about what health care procedures may be withheld”:

The proposed regulation completely obliterates the rights of patients to legal and medically necessary health care services in favor of a single-minded focus on protecting a health care provider’s right to claim a personal moral or religious belief.

For the Bush administration, the new regulation is a bridge to limiting women’s access to reproductive services. They hope to muddy the waters and threaten “both the diversity of beliefs in our pluralistic society and the health and well-being of patients seeking care.”

UPDATE: Time is running out but there’s still a chance to act. You can submit comments on the regulation here or by emailing your comments to consciencecomment@hhs.gov by 11:59 pm EDT Thursday, September 25th.