A new study from the Kaiser Family Foundation shows that out-of-pocket costs paid by insured workers have steadily risen as employers turn to high-deductible plans. Average out-of-pocket expenses have more than doubled in the last 11 years; in 2015, the average is $1,318, while in 2004 it was just $584. The rise in medical costs hasn’t been matched with wage increases either. Wages have increased by just 10% since 2010. Deductibles, meanwhile, have risen 67% over the same time span. Higher deductibles are supposed to help keep insurance premiums low, but they’re been increasing too, up 24% since 2010. Overall, 81% of insurance plans now have deductibles, and 24% of workers are covered by employers in “high deductible” plans.