More find health care unaffordable, are underinsured — 2 Comments

  1. You make good points. It is hard to imagine the benefit of coverage for which you pay substantial premiums and then have to meet high coinsurance/deductibles before it covers anything. I am not familiar with the details of the various plans but aren’t some routine services covered at no additional cost? So that should be part of the calculation (immunizations, etc.) Those who are covered by employer plans have their portions of premiums deducted from payroll before they ever see it. That probably makes it a lot more palatable for most folks, who rarely consider the actual costs of their plans. And the premiums are deducted on a pre-tax basis so they are somewhat reduced. On the other hand, if the family you describe had no coverage at all, they are exposed to open-ended financial risk if someone needs open heart surgery or chemotherapy or another fairly common course of treatment. I think those numbers are so big that most folks cannot even imagine actually paying them off. And many don’t – it goes to bankruptcy. So, ACA, in my opinion, is more about protecting medical institutions and managing taxpayer subsidies to them than it is about individual relief. I think single-payer is the best option — everybody’s in. Leave your employer out of your healthcare and a lot more folks are contributing to the pot.

    • Hi, Laurie, yes, some preventive care is covered at no cost (other than higher premiums!). Most immunizations, an annual exam and some screening tests. Of course, if you’re feeling ill and know you have a $1,000+ deductible, you will be less likely to see a doctor unless it’s an emergency. Despite what the ACA has done to expand coverage, the cost of insurance is still just too high, and those of us that buy individual plans, on or off the exchange, pay premiums with post-tax dollars, unlike employer-based coverage. Also, the risk pool is smaller and sicker, leading to higher overall premiums.

      Rather than move directly to single payer, I would 1) like to end employer-based coverage so that everyone is in one big equal risk pool and insurance companies can be more competitive; and 2) regulate and standardize health care costs. We have to know what things cost up front, and those costs have to be reasonable. (I’m looking at you, Big Pharma!)

      But Labor and Big Pharma are huge political lobbies, so I don’t see such changes happening anytime soon, sadly.

      Cheers and thanks for commenting! FN