Anyone see the New York Times yesterday? A new study shows that health care costs for family coverage have risen 9% for employers in the past year.
Concerned about that? Concerned if you’re working and covered? If you’re working and not covered? If you’re looking for work?
What about your friends and family that may have jobs now, but who knows when it comes to tomorrow?
As the article suggests, rising medical insurance costs may mean employers have one more reason to reduce staff or stall hiring.
And might I add that the way group health insurance costs are calculated, the demographics of the employee population are paramount? Don’t you think it’s more expensive to insure somewhat older workers than 20-somethings or 30-somethings? Think Human Resource executives aren’t fully aware of this fact?*
The more we seem to learn, the more the healthcare conversation in this country grows more frightening, more critical, and more pervasive in terms of who will be impacted and how.
May I share one of the key paragraphs from the article with you?
A study released on Tuesday by the Kaiser Family Foundation, a research group, showed that the average annual premium for family coverage through an employer reached $15,073 in 2011 — 9 percent higher than in the previous year.
Healthy or Not: Headaches Ahead
Yes, I’ve had my own health-related headaches, and ridiculous runarounds over simple things – accident injuries that were never properly treated, a common and easily addressed vitamin deficiency. But the real headache I live with is agonizing over the expense of even a limited medical insurance plan for which I pick up the full premium – of course – as an individual.
And with each passing year, attempting to contain the (outrageous) increasing price tag for (questionable?) occasional care, I run the usual cost-benefit analysis:
- alternate (lower quality) insurance vs my current provider
- no insurance vs my current provider
- catastrophic insurance only, vs the plague that is my current monthly expenditure.
And incidentally, I have already “downsized” to the most reduced coverage possible within my category type, which means a very high deductible and co-pays, with limited office visits.
Might I add that I’m basically very healthy, and immeasurably grateful for that fact? Yet my insurance increases yearly, and by a good deal more than 9% at that.
Healthcare News & Blues
I plan to read the entire study (available online), although I find myself both drawn to and repulsed by each report I consume on our mystifying medical messes – moving from headache to heartache – not only for myself, but for my sons and their future. For all of us and our future.
As for concerns about accessibility, quality, and cost of medical services – some of you share them already. Some of you may feel “safe” for now. But I daresay that no one is safe.
Care to peek at this recent piece in the Times by Tara Parker Pope, on RUC – the group that sets standard rates for physician pay? It is a group with extraordinary influence and innumerable ripple effects, as a select few establish prices for procedures that encourage physicians to go into specialty areas, while diminishing the ranks of many of us need most, for simpler (less expensive) primary care.
“…by allowing the continued devaluation of primary care services relative to work performed by specialists, the RUC perpetuates a health care system that not only fails to respond to patient demand but also, bizarrely, actually offers disincentives to attend to patient needs.
Future Heartache?
I really don’t believe in scare tactics, but I’ve learned the hard way in life that head-in-the-sand leads to butt (and everything else) out-in-the-cold. I don’t know about you, but I’m worried.
I’m worried about a system in which a small group sets prices, which in turn encourages medical students to specialize at least in part to repay their monstrous educational debt (another problem).
I’m worried about a system in which physicians are caught in the cross-hairs between patients, lawyers, and insurance companies in a nation so litigious that doctors must carry hefty malpractice insurance, which surely contributes to the problem of rising costs and excessive, unnecessary diagnostic tests, among other things.
I’m worried about a system in which “heroic efforts” are expended to save the 90-year old on his or her deathbed, but millions of us can’t afford the occasional X-ray or MRI.
I think we all know this is a runaway train, and we have to stop it. But it seems to be so large, so complex to operate, and barreling ahead at such alarming speed, we don’t know how.
And that worries me even more. Because we all know what happens to a runaway train, eventually.
*For a quick overview of how Group Health Insurance works, this “small group” overview explains that cost is based on geographic area and projected utilization of services, which is a function of claims history, as well as age, sex, and medical history. Note that group health insurance is regulated at the state level.
You may also read more via the National Association of Health Underwriters.
© D. A. Wolf
I felt sick when I read this most recent article: http://www.npr.org/2011/09/26/140827513/govt-wont-seek-appeal-in-atlanta-on-health-care because of the lack of sharing AND lack of responses. It is almost like we’ve given up as a country on ever getting what we need.
Soon I will have a full-time job. However, that job WILL NOT pay enough for me to use their health insurance they offer to all employees; in fact, our family is well below the poverty line and, thus, qualify for medicaid. While some people might judge and/or disagree with my using this, they are usually coming from a place of privilege, a place where they don’t have to choose between food and health insurance. With all the debt we have, and the fact that it is increasing by $40,000 every effing year (thx, med school), I cannot feel guilty over using a service that is meant to help me and other families in our situation. If only people could see how much our health care system is leaving families like ours (mine, yours, and others) in severe poverty and knocking us down when we are trying to get up.
I am frickin’ terrified. And we will be okay in a few years, but what about other people who don’t have the future that we do?
Did you read my post – “Healthy or Unhealthy: A Conversation” (https://dailyplateofcrazy.com/2011/07/13/healthy-or-unhealthy-cultural-commentary-a-conversation/)?
I ask because it summarizes a casual discussion I had with a young woman (30ish), and reflects the prevailing ignorance in this country. That ignorance is not mean-spirited, but it is deeply ingrained. And terrifying.
As you point out – this isn’t just a problem for the “40+ crowd” – it’s a problem for all of us.
Yes, we are on a runaway train. And I don’t really know WHO the conductor should be! As a business owner, I can understand the reluctance to hire, knowing that staggering health care coverage could compromise the company’s profitability for everyone. Yet, as a company grows, the need for employees does too. And I would rather take a beating than call an insurance company with a question about a claim. AND it makes me sick how much insurance company owners pocket each year. But I don’t think the government is the answer either. So many questions. So few answers.
Healthcare is a horror in this country. Insurance premiums for my family are more than our total income, by a HUGE margin; and because we don’t have minor children we don’t qualify for government “help” for healthcare, either.
Spiraling medical costs have led to spiraling insurance premiums; and the greed of the pharmaceutical companies; insurance companies; and even a few doctors, hospitals, medical schools, and malpractice lawyers; has made the situation even worse. Doctors and hospitals are forced into contracts with insurance companies that pay as little as possible for everything, then those of us without insurance are charged double and triple prices for care to make up the difference.
Since the uninsured don’t have insurance because they don’t have money to pay for it, they’re forced into “emergency only” care (no money for insurance means definitely no money for $200 visits to the doctor for basic care,) and frequently have to default on paying for that; making the situation even worse.
I don’t know what the answer is, but I do know that if things continue as they are, things are only going to get worse.
I’m in a similar situation, Wendy, except at the moment, there’s one of me.
I recently received the bill for my teenage son’s ER visit when he was in a boating accident in August. To the best of my knowledge, there were a few minutes with a doctor and two X-rays. The total came to a bit under $400. Waiting on the insurance company to see what’s next. Think about that sum – for something very simple, and very commonplace.
It’s deeply upsetting that healthcare costs are the difference for so many when it comes to staying afloat financially. The thought that a parent might have to forego medical for her child (or herself) simply because she can’t afford it (yet doesn’t qualify for government assistance) makes my stomach turn. Take one look at the itemized bill I received from the hospital after my month-long stay this winter and it’s hard not to laugh – and then cry – at the prices we are charged. As you point out, it’s a vicious cycle. Any brake in sight for that runaway train?
My second largest monthly expense is for healthcare and that is for a family that is healthy. We are fortunate that we haven’t had any major issues.
Typically we visit the doc for physicals and the occasional illness. I am disgusted by how much it all costs. There is something very wrong about this system.
Crazy, I think our minds are in the same place today. After hearing about my sisters hysterectomy and the costs she will now incur (while working part time at a superstore) without insurance, I was about to do some figures myself on just how much money your average citizen puts into the pot every year with deductibles, premiums and out of pocket medical and dental. Just so that I could compare that with the amount of medical each family actually uses per year. It seems there is a lot more money going into the pockets of the insurance companies, the medical device and supply companies (which has been the source of my own bread and butter for many years) and the care providers themselves. It seems to be tilted to the latter.
I have been unemployed for fifteen months, am above the poverty level still and we have been praying that nothing happens to my health and that of my youngest. Their father should be covering them but is not. Luckily, my two older children are able to receive insurance from their employers – at a price.
This is definitely a broken system. But we as citizens also have a part to play in the frivolous lawsuits and fraud cases causing inflated costs to skyrocket. We are certainly not the best health plan in the world.
Not only are we not the “best,” NAS – the articles I cited in “Healthy or Unhealthy (A Conversation)” point out that we were ranked 37th in the world, and:
Couldn’t we point to health care as delivered in France for example, ranked a few years back as number 1 in the world (the U.S. was ranked 37)? Could we mention the per capita cost of $3,500 per person, which is considerably less than the $6,100 per person in America? Or might we point to Germany or even Canada – and say – no, none of these are perfect systems, but they offer excellent care which is not a function of whether or not you’ve been “downsized” or you’re poor, or you’re of a certain age and no longer employable, or you do or don’t have an employment “relationship?”
Well, the care here on our own soil is worse than excellent especially if you do not have health insurance coverage. As you say, at least you are covered (in other countries) when ill, AND lucky enough to be covered when out of work or unable to afford coverage.
What will happen if they require us to have insurance?
Enacting law that says we are “required” to have health insurance seems ass-backwards to me, personally. We ought to have a law that says we receive adequate medical care, period. But that’s another (albeit related) discussion.
May I mention that I have (theoretically) “mainstream” insurance, but that doesn’t mean it isn’t utterly unaffordable, the pricing for the services provided – ridiculous (be sure to read the article by Tara Parker-Pope on setting of prices on 10,000+ medical services by a group of 29 individuals), and nor does it mean that the quality of the doctoring will be anything other than mediocre. You get whomever happens to be in-the-plan-and-available, and quality is all over the map.
As to requiring insurance, I wonder if that would be enforced with the same success rate as payment of child support – because you and I both know how easy it is to enforce that particular requirement, right? (Insert cynical grin here _________.)
While I understand the frustration when it comes to prices in the ER and how much a doctor charges–that isn’t exactly the problem. I mean, it is one problem, but a much bigger thing is not focusing on preventative care and getting people in to see primary care physicians, nurse practitioners, or physician’s assistant. If you look at the itemized bills on any ER bill, you will notice that a doctor’s pay is significantly less than the equipment, the stay in the room, and even the little things–a thing of vaseline, for instance. Also, keep in mind that the government is regulating a doctor’s pay more and more while not compensating them nearly enough for how much they are paying out in loans AND for the procedures they do. To expect a physician to pay for the surgery himself–while gov’t insurance and other insurances companies refuse to pay the cost of what they procedure was itself–is wrong and keeps things very difficult for all physicians. While I am not disagreeing that greed exists in the healthcare field, to assume that the physicians are creating the mess is to forget that policies are being made without the oversight of physicians–it is being made my policy makers with little or no understanding of healthcare issues. Kind of silly, don’t you think, to regulate healthcare without consulting the dispensers of this aide, i.e. the physicians?
I think the “runaway train” comes from policies that are hindering physicians, patients, and the entire health care system. It’s complicated. So very complicated.
Touche’ 🙂
A similar thing happens in public education where primary teachers get the roughly the same respect in their profession from the political powers as primary care physicians get in theirs. In both situations, it can be argued that they are the professionals most crucial to the systems in which they work and the least rewarded financially. Teaching a child to read may be the most critically important thing any professional does in our society while coordinating care for a patient and assuring continuity through this fragmented system is surely one of the most challenging specialties in medicine.
When I get a bill from my PCP for $5 for “RX without office visit” I am reminded of her value in making the system work as efficiently as it can for me and the way she is forced to struggle for nickles and dimes to keep the system afloat.
Nice comparison, Timothy.
Great post! This scares me more than any other topic except hunger (not my own). I am not a fan of being a Navy wife but having healthcare makes it worth it (almost). Am reading about the latest Supreme Court case of Obama Care. I hope it makes it out – personally, I think he had good ideas and I wish that bipartisanship didn’t make everything so effing hard.
This hits close to home as we struggle to raise $175,000 for my sister’s kidney transplant that Medicaid is refusing to pay for. However, she couldn’t buy health insurance from any other provider even if she had a steady 40-hr/wk job because of her pre-existing condition. So she can’t buy coverage and the system won’t give her coverage, so she must pay out of pocket for a kidney she’ll take great care of.
Meanwhile, someone who’s smoked and drank most of their lives, and likely will again, can get a transplant easy-peasy for a fraction of the cost because the system is set up in their favor.
I could talk about this all day.
This is heartbreaking to read, and must be excruciating to live. Tell us how we can help, Kelly. Please.
What I find funny is that there are already solutions to our country’s healthcare woes, if only we look outside our borders. Universal care is not perfect but it is so much better for the average citizen (the majority) than other current systems. Yes, there is bureaucracy but there is a lot of bureaucracy in our current system especially since insurance companies often deny treatment for profit-reasons and billing errors are common since hospitals / doctor offices must deal with coding for many HMOs /PPOs instead of one. Plus, if you look into it, Europeans also have private options that are more expensive but no one has to raise money for medical bills or go bankrupt for medical reasons.
We have the most inefficient health system in the world; basically a cash conduit to keep lots of people employed doing paper work while a few are getting rich and even fewer are doing the actual medical work. For-profit companies controlled the most recent government changes — covering more people in exchange for lots of inefficiencies and profits. Single payer is the way to go. You say our government can’t do it? Then it’s not the fault of government per se (it works in lots of other countries), it is the fault of OUR AMERICAN GOVERNMENT, which has become so politicized and corporate-controlled as to be nearly dysfunctional (“nearly?” — perhaps I am too kind.)
I am back from visiting with my mother who is 101, and her recent operation on a fractured hip was covered by medicare. Some things do work.
Re the variety of comments here and your comment elsewhere about the successes and failures of medicare/medicaid: It’s good to be appreciative when the medical system does work, but we agree that it could be much better. Interesting that there is a legal protocol that surgery had to be done on my mother with a broken hip. But after that, there is much leeway in the amount of pain medication that is given. I have to wonder that they did their legal duty to operate, then had her out of the hospital in two days so she wouldn’t die on their hands, and then prescribed her enough morphine to ease her through the end of life over the next few weeks or months. This might all be standard with modern medicine (for better or worse).
Perhaps it would have been better to leave things that way, but we insisted that the morphine be removed, at which point she improved dramatically almost immediately and has no pain. But in prolonging her life will we eventually be producing more pain and suffering? But can we or the medical profession make that decision?
That is not a rhetorical question — if she suffers in the next few months, perhaps it will have been the wrong decision. But we will also have the fact of a good visit that would NEVER have occurred with the prescribed morphine. And the morphine option will continue to be available to us (the family) as our decision, if we put her on hospice care. It is likely better that the family (assuming they can be fully informed) take responsibility for that decision and not the medical profession.
Coverage for all.
Reasonable costs.
No compromises in the amount of care.
In an ideal system, we can have two of the above, but not all three.
And quality of care, Wolf?