survival

Having that high-deductible health plan might kill you, literally

Having a health insurance plan with a high deductible could not only cost you—it could also kill you.

A new study in JAMA Network Open found that people who faced those high out-of-pocket costs as well as a cancer diagnosis had worse overall survival and cancer-specific survival than those with more standard health plans.

The findings, while perhaps not surprising, are a stark reminder of the fraught decisions Americans face as the price of health care only continues to rise and more people try to offset costs by accepting insurance plans with higher deductibles—that is, higher out-of-pocket costs they have to pay before their health insurance provider starts paying its share.

The issue is particularly critical right now for people who have insurance plans through the Affordable Care Act marketplace. Prices for those plans have skyrocketed this year after Congress failed to extend critical tax credits. Without those credits, monthly premiums for ACA plans have, on average, more than doubled. Early data on ACA enrollments for 2026 not only suggests that fewer people are signing up for the plans, but also that those who are enrolling are often choosing bronze plans, which are high-deductible plans.

In the study, researchers considered plans to be “high-deductible health plans” (HDHPs) if their deductibles were at least $1,200 to $1,350 for individuals or $2,400 to $2,700 for families between 2011 and 2018 (with the cutoffs increasing within the ranges during that time). For context, the average individual deductible for an ACA bronze plan in 2026 is about $7,500, according to KFF.

Risky plans

Based on previous data, such high out-of-pocket costs are known to lead people to delay or decrease health care—they may skip doctor visits, put off diagnostics, and avoid treatments. But for the new study, researchers led by Justin Barnes at Mayo Clinic in Rochester, Minnesota, wanted to know, more directly, if the plans were linked to lower survival—specifically for cancer patients, who obviously need more care than others.

Stalker 2 has been enjoyable jank, but it’s also getting rapidly fixed

a-life, enemy ai, First-person shooters, gaming, gsc game world, npcs, stalker 2, survival / Mike M. / December 19, 2024

When the impossibly punctuated S.T.A.L.K.E.R. 2: Heart of Chernobyl released on November 20, after many delays (that included the Russian invasion of the developer’s native Ukraine), it seemed like it could have used even more delays.

Stalker 2 had big performance issues and game-breaking bugs, along with balance and difficulty spike issues. Some things that seem “wrong” in the game are just going to stay that way. The first-person survival/shooter series has always had a certain wobbly, wild feel to it. This expresses itself in both the game world, where a major villain can off themselves by walking through a window, and in the tech stack, where broken save games, DIY optimization, and other unmet needs have created thriving mod scenes.

Developer GSC Game World has been steadfastly patching the game since its release, and the latest one should nudge the needle a bit from “busted” to “charmingly wonky.” Amid the “Over 1,800 fixes and adjustments” in Patch 1.1, the big changes are to “A-Life.” In porting Stalker 2 to Unreal Engine 5, the developer faced a challenge in getting this global AI management system working, but it’s showing its weird self again.

A-Life, as detailed by Destructoid, is the idea that “the characters in the game live their own lives and exist all the time, not only when they are in the player’s field of view.” In a certain radius around the player, events happen “online,” in real time, such that you could stumble upon them. Farther out, things are still happening, and non-player characters (NPCs) are trekking about, but on an “offline,” almost turn-based, less resource-intensive schedule. Modders have had quite a bit of fun tweaking A-life in prior versions of Stalker 2.

With the latest patch, the weirdly engaging feel that the world goes on without you returns. There will be more NPCs visible, NPCs out of range will pursue their “goals,” and a more diverse range of human factions, mutants, and weirdos will exist. Perhaps most intriguingly, an issue where “Human NPCs didn’t satisfy their communication needs and talks” is fixed. If only that could be patched for most of us player characters here in the real world.

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