Affordable Health Insurance?


Open enrollment. If you have a business that provides insurance for employees or work in the department responsible for health benefits for employees, those 2 words evoke multiple emotions, mostly negative. Yes, we are grateful for the benefits that provide access to doctors, hospitals and medicine. Health insurance, however, is the necessary evil for access. And it keeps going up every year, and not by $10 or $20 a month but always $60 to $80 a month for the SAME policy. Will the rate increases ever stop?


This is NOT affordable health care.


There are policies with deductibles that are somewhat easy to meet giving the insured the ability to have routine doctor visits and to seek care when needed for issues that are not catastrophic but these are getting unaffordable. And there are catastrophic policies with very high deductibles so that a major health crisis like cancer will not bankrupt the insured or the professionals treating them. But a high deductible plan will not give the individual access to medical care until the high deductible is met so they must pay for the entire visit, not just a co-pay. Generally, that means the insured person, who is still paying quite a bit of money every month for “health benefits” along with his employer, still cannot afford to see a doctor. These deductibles are $5000 and up which is a lot of money.


Then there’s the other side, the doctor’s side. My son-in-law is a doctor practicing in Oregon. He graduated from medical school with huge student loan debt requiring a huge monthly payment (more than his mortgage). We talked about health insurance on our last visit and he gave me another point of view. As a doctor, when an insured patient is seen, they are responsible for their co-pay at the time of the appointment. They are treated by the staff of the practice and the bill for services is submitted to the insurance company by the billing department. If the patient’s high deductible has not been met, the insurance company denies the claim and the practice receives zero for the balance of the cost of the visit. So, they then bill the patient for the remainder of the cost of the visit. The patient often does not have the money to pay the bill, or won’t pay the bill and the practice loses money for seeing that patient. It happens a lot with high deductible policies and it hurts medical practices, and they have many bills to pay including very high malpractice premiums on top of everything else a business must pay to well, stay in business.


Running a medical practice isn’t cheap and the days of making big salaries for doctors are gone for many. Lower pay, high student loan debt and high malpractice insurance rates = many gifted students avoiding medical school and going to law school instead. Goodness knows we need more doctors and less lawyers!


So, who’s making money besides lawyers? Insurance companies and it can’t go on! Premiums for decent health care (not just catastrophic) need to stabilize and decrease. Now give me a candidate who can really repair our health care system and take the power away from insurance companies and I’m all ears.


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