So, I guess I’m supposed to have a crystal ball now. That’s what the health insurance rep told us last week at one of the company’s annual open enrollment meetings.
The trick to picking the right health insurance plan, he explained, is to start by looking at the premium to see what fits in your budget. But before signing up for the one with the lowest sticker price, you’re supposed to “take out your crystal ball” to determine how much health care you and your family might need in the coming year.
That way, you’ll know if you can save a little money with the high-deductible/low-premium plan, or shell out for richer coverage with a more expensive policy.
Here we go again. Another year, another health insurance information session, another season of frustration.
NOT A CLAIRVOYANT
I don’t blame the insurance rep – he didn’t design a system that requires me to be clairvoyant. But I shouldn’t have to be. And I don’t need a crystal ball to know there’s going to be more frustration in the year ahead as I find out what’s covered and what isn’t.
Every provider has a different price for every payer, and the difference between a no-cost test and a $1,000 bill is a little piece of code typed in by someone who probably can’t tell me how much I’ll have to pay.
I’m supposed to shop like a good consumer for services even though I don’t know how much they cost and, in many cases, I wouldn’t be in a position to walk away if I didn’t like the price.
I keep trying to tell myself that I’m one of the lucky ones because I have insurance through work.
When we debate health care policy, most of the focus is rightly on the people who don’t have coverage, like low-income people who don’t qualify for Medicaid, or self-employed people who can’t afford insurance because they make a little too much for an Obamacare subsidy.
I’m not one of the people who has to go to the emergency room for a toothache and gets painkillers, antibiotics and advice to see a dentist that I can’t afford. I don’t have to skip the tests my doctor orders or leave my prescriptions unfilled.
Like about half the people in the country, I have insurance through my employer, which means that I get left out of the discussion about health care reform because I’m supposed to be OK. But I would like to go on record to say that I am not OK, and I don’t think I’m the only one.
Health care costs are expected to grow by 5.5 percent next year, faster than the gross domestic product and twice as fast as wages. Workplace insurance coverage pays roughly $1.4 trillion of the nation’s annual $3.3 trillion health care bill.
The cost of private health insurance has tripled since 1990, also easily outpacing wages.
According to an annual study by the Kaiser Family Foundation, the full cost of the average individual plan in 2018 was $6,896, and $19,616 for a family. Most of that is paid by employers, but the average worker is responsible for about $1,100 a year for single coverage and $5,500 for a family plan.
Meanwhile, the amount that these people have to pay out of pocket before they can use their increasingly expensive insurance – the deductible – has also skyrocketed. Average deductibles have climbed 212 percent in the last decade, from just under $600 a year to more than $1,500. So, if you find that you are paying more of your stagnant wages for health insurance that doesn’t cover as much as it used to, you are not alone.
TIME FOR A CHANGE
These trends are what makes universal health care proposals like Medicare for All more politically palatable all the time.
Every other developed country manages to cover everyone at a lower cost with better results than we do in the United States. We waste billions on complexity that masquerades as choice. People say that government can’t be trusted to deliver health care, but I don’t hear a lot of seniors on Medicare pining for the days when they had private insurance.
Here’s my question for policymakers: Is what we’re doing now really the plan? Are we really expecting that most people will be able to pay more money every year for insurance that covers less, and requires them to blow through their savings when they get sick? And are we going to keep telling these people that since they have insurance they are “the lucky ones?”
Because I may not have a crystal ball, but I’m willing to predict that this plan isn’t going to work much longer.
Greg Kesich is the editorial page editor. He can be contacted at:
Twitter: gregkesich
Send questions/comments to the editors.
